As a director of psychological health and a Soldier who has deployed several times, I have reflected on the behavioral health issues that confront Soldiers at all levels of service, especially in view of the publicity this has gotten in the past few years.
Many civilians seem to think that the majority of service members have, or are subject to, behavioral health disorders — of which the most likely candidate is Post Traumatic Stress Disorder. There is also an opinion that if you have a disorder such as PTSD, you have a serious medical illness which will lead to continuously degrading capabilities, relationships and career achievement.
This is not true or even close to the truth as regards to behavioral health issues or PTSD for Soldiers, most of which recover and lead highly successful lives.
Where the Army specifically — but also the services in general, particularly with ongoing treatment through the VA — differs from the civilian community in meeting the challenge of behavioral health needs is that the U.S. military has tried, with increasing success, to actively address these issues. This has led to the transparency of behavioral health issues both in terms of incidence and treatment to everyone as the Army tries to decipher and measure the problem.
Essentially, the Army — in a broad-reaching effort to normalize stress reactions and increase its cultural competency in addressing them — has put itself under a microscope.
I started in developing behavioral health, or combat operational stress, services in the ’70s, shortly after the end of the Vietnam War — and at that time both, the level of resources and treatment of behavioral health issues in the Army were minimal to say the least. I was involved in developing effective battlefield treatment strategies both in working with the schoolhouse at Fort Sam Houston and in operationalizing methodology during many exercises and while deployed during Operation Desert Storm.
Such services were often marginalized or discounted as being unnecessary in the Army’s inventory of deployable units and services. Fortunately, a few very committed advocates were able to maintain them.
Slowly the recognition of the value of such services grew, as the recognition of the effectiveness and humanization of treating behavioral health issues in the Army increased through the years. The corresponding issue of TBI recognition grew with the advent of Operation Iraqi Freedom/Operation Enduring Freedom, as well as a higher level understanding of the effectiveness of behavioral health treatment in maintaining the fighting strength on the battlefield.
Concurrent with OIF/OEF, the Army launched a campaign with the advent of Battle Mind training — now replaced by the more useful and functional Resiliency Training — to help Soldiers understand that the emotional reactions they are experiencing are in fact often normal reactions to abnormal experiences or stimuli. The Army has developed far-reaching and effective programs to deal with the ever-concerning issues of suicide.
During most of my career I was a reserve Soldier, working in the civilian sector and providing, supervising and managing behavioral health services. Never in my civilian career have I seen the organizational commitment, along with the financial commitment, to address behavioral health issues that the Army has displayed over the last decade. The cultural change of the Army over that period — and it is still in transition — is dramatic.
We now understand that Soldiers who may have such issues are fully capable of performing their mission once they gain an ability to manage their affliction. In fact, they may be stronger in their performance than before — and an effective mentor to help others undergoing such issues to understand and get assistance to manage their distress.
While headlines focus on problems facing “broken Soldiers,” the military’s effort to deal with, normalize and overcome those behavioral health issues gets scant attention. My belief is that, thanks to those efforts, we have a more self-aware, less stigmatized and effective force than we have ever had.
Can we make improvements, especially in our understanding and effective treatment of behavioral health and stress issues? Of course. Having said that, I believe the Army at this moment is well positioned to effectively respond to a Soldier experiencing such issues.