Stigma Keeps Troops From PTSD Help

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More attention has been paid to the mental health of American troops in Iraq and Afghanistan than in any previous war. Yet shame remains a significant barrier to military personnel and their families getting the psychiatric treatment they need, a report released Wednesday says.

The good news is nearly three-quarters of the 200 military men and women interviewed by the American Psychiatric Association (APA) said that it was very or somewhat easy for them to seek out mental health care. But 60% still feared that doing so could have negative consequences on their career. More than half reported they believe others would think less of them if they sought out counseling, and most surveyed said they have rarely or never spoken even to family and friends about mental health issues. These numbers show "there's still a long way to go towards reducing the stigma surrounding care," says APA board member Dr. Mary Helen Davis.

The APA's findings echo previous studies on the mental health toll faced by the more than 1.6 million U.S. troops deployed to Iraq and Afghanistan. In a comprehensive survey released this month by the think tank Rand Corporation, researchers concluded that nearly 20% of returning military personnel from these two fronts — about 300,000 service members — suffer symptoms of post-traumatic stress disorder. Left untreated, PTSD and depression could cost the nation as much as $6.2 billion in medical care and indirect costs during the two years that follow deployment, the Rand researchers estimated. "We need to remove the institutional cultural barriers that discourage soldiers from seeking care," says Terri Tanielian, one of the report's authors. "It's going to take system-level changes to improve treatments for these illnesses."

Both the APA and the Rand study call upon the Pentagon to do more to promote better mental health care among its troops. On Thursday, Secretary of Defense Robert Gates is expected to announce a policy shift to no longer require military personnel applying for security clearance to disclose psychiatric counseling. Currently applicants are asked whether they've undergone therapy within the last seven years. The most recent data showed less than 1% of some 800,000 people investigated in 2006 were denied solely due to their mental health profiles, according to the Associated Press. Still, the new change seeks to ease the stigma throughout the military regarding mental health problems.

Nonetheless, service members often find it easier to seek therapy outside the military setting than within it, the APA study also concluded. Nearly half of those surveyed said that they didn't know the warning signs of mental illness, and one-quarter knew nothing at all about effective treatments. Republican Senator Kit Bond of Missouri hopes to improve that. He plans to introduce legislation Thursday that would dramatically expand care options for active-duty troops. Right now they can seek therapy on military bases and national facilities such as Maryland-based Walter Reed Hospital. If passed, Bond's bill will give them access to Veteran Administration treatment centers as well. It will also increase the number of military mental health care professionals and extend survivor benefits to the families of service members who committed suicide.

Also within its report, the APA presented one of the first pictures of the effects of war on the mental health of military spouses. Predictably, about 70% of those surveyed said they worried that their loved ones would be harmed or killed in battle. But nearly two-thirds also reported that handling domestic issues alone or being a single parent was a major source of stress. About 12% said that they feared their spouse would resent them if they sought out mental health treatment. So reluctance to get help for PTSD affects more than the soldiers themselves, Davis says. "Whole communities will have to deal with the consequences," she says. "It will be a tremendous public health problem for all of society."