Troops still wary of admitting mental health problems

By Gregg Zoroya, USA Today

Source: Military Times
Published: Tuesday 02 July, 2013

America’s combat troops are no more willing today to seek help for mental health problems than they were a decade ago, a failure stoking record suicides that have haunted the military in recent years.

In a confidential survey of troops in Afghanistan last year, nearly half of those in the Army who reported psychological issues said they would be seen as weak if they sought help. Sixty percent of Marines with mental health problems responded the same way, according to the latest in a series of Army war-zone field studies.

These sentiments come despite years of Pentagon programs aimed at combating stigma — urging troops to seek help, increasing access to behavioral health specialists and assuring service members that their careers will not suffer.

“Despite efforts to reduce stigma ... there still exists latent tendencies to view seeking behavioral health care as weakness,” Army spokesman George Wright said, responding to the report. “Leaders at all levels must continue to resist this culture by associating help-seeking behavior with strength-seeking behavior and by embracing the benefits of increased individual resilience.”

Suicides across the military, including the Army, reached an all-time high of 349 in 2012. Army suicides this year are tracking higher than 2012.

A copy of the war-zone study — completed in March but not released by the Army — was obtained by USA Today. It is the eighth such war-zone study since 2003, and a review of previous versions shows attitudes on stigma have remained virtually unchanged.

Experts including John Roberts, executive vice president of the Wounded Warrior Project, say troubled troops and veterans often wait until they are too sick — in emotional crisis — before receiving help, creating fertile ground for suicide.

“That is the warrior mentality,” says Roberts, himself an injured veteran of Marine Corps. “The military mentality is not to admit you have a problem.”

A second internal study by the Army, also obtained by USA Today, offers insight into which troops are most at risk for killing themselves.

Two key categories are troops who have just been released from psychiatric hospitalization and in the first few months after that release; and those who are on or have just completed their first combat deployment.

Scientists analyzed Army suicides between 2004 and 2009 and found that those within one month of a hospital discharge and who had a psychiatric issue were 20 to 60 times more at risk for suicide than average soldiers. That excess risk declines in the months after discharge and goes away after a year.

Wright said the Army, aware of the risk among troubled soldiers released from hospital care, are now seeing 90 percent of them for follow-up appointments within seven days.

The findings are part of a $65 million, five-year joint research project by the Army, the National Institute of Mental Health and a consortium of universities, begun in July 2009.

The research was reported to Army Secretary John McHugh and Gen. Ray Odierno, Army chief of staff, in April. Researchers told the leaders that they have developed a formula for identifying troops who need additional monitoring.

Project scientist Michael Schoenbaum, in an interview with USA Today Tuesday, said it is possible to use Army and Pentagon data on troops “to identify sub-groups of soldiers with systematically elevated suicide risk.”

They also reported that suicide rates spiked among soldiers after their first deployment and remained high for a year or more.

Scientists also found a strong link between psychiatric disorders and concussions or mild brain injury from a blow to the head. They found that up to 60 percent of soldiers suffered a mild brain injury during their lives — an injury common during sports — and most of those reported the first injury occurred before entering the Army.

Researchers found an increased risk of a first suicide attempt among soldiers serving in the infantry and artillery and as a special operations communications sergeant, cavalry scout, combat engineer and crewmember on an M1 Abrams tank. For female soldiers, the highest risk for a first suicide attempt is in the first year of service.

The rate of first-suicide attempt tripled among soldiers in their second year of service who were told they had a psychiatric condition that might limit their ability to perform assigned duties, according to the research.

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