Checking the Mental Health Block

“Next,” said the voice from a tiny cubicle.

A sign facing the door labeled it “Office #5.” It was just one tiny office among six others, with only a thin partitions separating them. I walked in. Behind the desk sat a kind looking lady–imagine a standard issue government employee and you got it–who motioned me to sit in the chair next to her desk.

A few minutes before, I’d received my redeployment paperwork, a glorified checklist. Once I filled it out, it meant I was home, safe and sound. I handed it to the mental health worker.

If you’ve spent more than a minute in or working with the Army, then you know what “checking the block” means.

“How are we doing today?” she asked.

“Pretty good,” I replied. “You know how it is trying to get all these signatures and stuff.” She just smiled in response. I tried to project confidence. Projecting confidence means you aren’t crazy.

The Army lives and dies by checklists. Need to set up a range? Instead of sitting down to figure out all the inherent risks, just find a previous range “Composite Risk Management” form, and change the names and dates. You’ve checked the range safety block. Need to conduct a battalion-sized operation? We have a checklist for that. Need to deploy? We have a pre-deployment checklist. Need a physical? Fill out the online Periodic Health Assessment, a checklist. Need to invade a middle Eastern nation? I’m sure there was a box to check for that too.

I had just returned from my second deployment, my first to Iraq. I was at Fort Campbell, a post that has led the Army in suicides in the past (though they don’t advertise that at the front gate). I was sitting down with a mental health worker to discuss my recent deployment. Unfortunately for me, and thousands of other soldiers, I was just checking the mental health block.

As the Army struggles to explain why suicides are climbing, they ignore a fundamental problem–a culture of checking the block. And when the Army “checks the mental health block,” it eventually impacts the Veteran Affairs department. An Army that “checks the mental health block” effects our whole society.

The mental health professional read aloud the questions I had just filled out. I reanswered each question.

I glanced up at the cubicle walls separating us from the other offices. Anything I said could be heard by all my peers waiting in line twenty feet away. Was I having trouble sleeping? (No.) Did I see any fighting downrange? (No.) Was I having nightmares? (No.) Was I drinking too much? (Nope.) I answered every question as quickly as possible, like the dozens of other Soldiers with me. All I cared about was getting through this as quickly as possible without getting the (undeserved) stigma of PTSD.

Recruits check the mental health block and hide any previous mental issues as best they can. (Jared Loughner tried to join the Army. Initial reports labeled him a veteran. Follow up reports said the Army didn’t accept him because of mental issues. To be clear, he admitted to habitual drug use.) Deploying Soldiers check the mental health block before deployment to keep their pay check coming. Redeploying soldiers check the mental health block for a variety of reasons–to get back to drinking, to protect their careers, or to avoid more questions.

And the Soldiers who don’t check the mental health block face a much more dire future: getting thrown out without any support. Two years ago, Congress specifically directed the Army to stop discharging Soldiers for “pre-existing personality disorders” if the Soldiers really had PTSD. Instead, the Army has had a 165% increase in discharges for “adjustment disorders.” Both conditions, pre-existing “personality disorders” and “adjustment disorders,” deprive discharged service members of eligibility for medical care from the VA.

In all, it took me less than three minutes to complete. I got my stamp, and I moved on to my next station. Could I have said more? Absolutely, that’s why I write a blog on national security, foreign affairs and, most importantly, my personal experiences.

Do I need to talk about my deployment? Absolutely, but not so it will jeopardize my career. I believe that, despite the Army’s assurances, it would impact my career, so I check the mental health block and move on.

The entire 101st Airborne Division is redeploying to Fort Campbell from Afghanistan in the next year. The process just started. I predict Fort Campbell will have a rash of suicides, even though it opened a new mental health facility. Even a new facility with dozens of new counselors isn’t enough to overturn the culture of “checking the box.”

Army suicides, PTSD, adjustment disorders, and the rise in military divorces have risen because of checking the mental health box. Instead of getting the counseling they need–Soldiers should have to sit down with counselors for time measured in thirty minute intervals, not five–Soldiers will get a checklist with maybe a dozen questions on it. The Army needs to remove the stigma even further from PTSD. We need to change a culture, a culture that checks the block, even in the most important areas.

Captain Michael Cummings writes for On Violence, a blog on military and foreign affairs written by two brothers–one a soldier and the other a pacifist. He is an active duty military officer who deployed to Afghanistan with the 173rd Airborne Brigade and recently returned from a deployment to Iraq.

The views expressed in this blog are those of the author and do not reflect the official policy or position of the Department of the Army, Department of Defense or the United States government.

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30 Comments to “Checking the Mental Health Block”

  1. Sven Morgan says:

    Unless forced into it, by usually a major event, no one ever checks the Mental Health Block, sees the ‘shrink’ or ever admits to mental problems. To do so will almost always result in having have your security clearance terminated or suspended. Such an action will most certainly result in loss of promotion, removal or non-consideration for a sensitive assignment or other measures.

    No matter what the eventually outcome the person never recovers from this action and is always suspected of being mentally ill.

    And you wonder why mental health issues are never discovered or acted upon until after the fact.

    • Steve M. says:

      Indeed, Capt. Cummings identified a significant issue, but even in doing so, didn’t really dig much beneath the surface. Your comment, Sven, puts the drastic nature of the organization culture in more perspective.

      To solve the “checking the block” culture problem getting at the underlying issues is crucial — or it will never get solved.

  2. Brenda Hayes says:

    Michael,

    First of all thanks for your service and thanks for your honest commentary.

    Keep up the good work with your blogs as well.

    As you well know, whether in or out of the Military, Mental Health has a long way to go; even though it has come out of the dark ages; still too much needs to be done especially with attitudes and old mindsets of mental illness.

    I prefer to still use the term that I thought would take the place of mental illness; neurobiological disorders. It does not have the old mindset that comes along with yesteryears attitudes.

    I think many people in the public have advocated for better knowledge and acceptance along the way; Ms. Rosylyn Carter, Ms. Betty Ford are just a few as well as several well known news reporters, I think among them, Dan Rather.

    In fact, I’ve read several articles by Psychologists and Psychiatrists regarding dealing with their own Depression and/or Manic-Depression (Bi-Polar.

    There has to be a “safe” place for active duty soldiers to go and seek help.

    At present, unless a directive comes down with major safeguards, I think our soldiers just see it is a set up as DOD is still speaking out of both sides of their mouths. Lots of Viet Nam Vets held onto careers in and out of the military by the skin of their teeth at times and used other coping devices such as moving on every so many years.

    Some career soldiers have PTSD and don’t even know it and others know something is wrong, but are quite good at hiding it. But eventually, it will bite you in your six!

    The advice I would give my son “….if you don’t want to admit that you are having problems because you want to stay in the Military and fear retribution; still get help now; it is up to you to become familiar with this disorder(s) and seek help outside of the system”. If it gets too bad and you can’t deal with it and you know you can’t stay in and get the help you really need…DO IT! There is no shame in asking for help; there is no shame in not being able to do what you used to do.

    There are other jobs/careers and/or other ways of life–it maybe different from what you thought it would be; but it can be a purpose-filled life with happiness and joy. No life is ever filled always with happiness and joy–that’s really not normal…”

    Of course, if someone does not want to stay in the military; then go seek the help that is there. I’ve heard that the VA supposedly believes that the quicker PTSD is “treated”; the better the outcome. I just don’t see “being cured”. I think you learn to live with it; making adjustments for the highs and lows, etc. But, first you have to know what it is and how it can get the best of you.

    Consider 12 step programs including the newer Dual Recovery Anonymous; Manic/Depressive Community Resources; seeking out someone trustworthy (maybe within your family or your Pastor/Priest; or the Wounded Warrior mentor Program (NP out of D.C. and your Recovery Coordinator at your VAMC.

    No matter what, I do support anyone to debrief from whatever your horros were. Grief is the main thing you will have to deal with–you have to grieve for you, the old you–even though you are different because of what you experiened it is normal–your normal as a combat Veterans.

    Honestly, I am not sure if there is any such thing as “normal”. Will you have to work a little harder to deal with this disorder? Of course. Can you “get over” it and have a better life?

    Well; you learn you are normal for going through what you have. You learn that no matter what you have been through you have already been through the worst part; you learn that you can’t go over it; can’t go under it; but you can go through it and come out the otherside safe and intact. A good therapist or treatment can really help with this; but you can also seek out the peer groups in the Community (if you are still active duty) and you can seek out a mentor in the Wounded Warrior Program.

    As I understand it, The Vet Centers were set up for this reason as the Vets returning from Viet Nam did not trust the VA, the system/the Government. I am not sure if you can refuse to allow your information (treatment) to be shared with the VA or the DOD. Also, I believe, that the Vet Centers will treat active duty as long as they have a combat/sexual stressors.

    Remind yourself and others daily: You never give UP!!

    BH
    Vetwife Advocate

    P.S. Alex…can you get someone from the NP Wounded Warrior Program (D.C) and the other DOD Wounded Warrior Programs; not sure if the VA has one as well(?)to do a guest commentary.

    I still think we don’t have a smooth transition to do outreach whether they are in or out of the system. How do we reach those in “trouble”; what can all of us do? what else can the DOD and the VA do?

    • Dennis Rick says:

      I reply to your comments about seeking help “OUTSIDE OF THE SYSTEM” and your still in. Lets see how far that flys if you have obtain a Top Secert SCI cleanance. They will find it, I promise you that. Then you have more to explain as to why you were hiding it.

      Things might be a “Little” better now then when I was in (Came in Aug 1965). However, if one wants to make a carreer out of the service back then, you better tell them you have a problem. And that goes for the Fed Gov’t empolyee as well. (I’m retired from both). So I can speak very clearly and straight forward about it. Its a different way of “Don’t ask, Don’t tell” You admit to a problem back then, kiss your carreer goodbye.

      I feel even with today standards they look at you with a wearly eye. There is no smooth transition no matter how much you put out there. You can just hope that it helps to cope with the situation as best as you can.

      I attended the Voc Rehab for Disabled Vets (Great program) however, do you know how many counsellors I went through in 2 yrs? Try around 8 or 10, yea in two yrs, they drop like flys in that program and that does not help the diaable vet one bit. For some are not so nice and some are. The you have to deal with the College and its counsellors and guess what, they have a high turn over rate also. You repeat yourself over and over and over again each time a new one comes along. And sometimes they take away from you what the other one granted, then the fights start. (I know for it happen to me) Then on top of that there is the college and the course’s. They do give us some lean way, but not a lot and when you pile on the ever changing counsellors and manage your home life, when your plate is running over. But the Voc Rehab Program is one great program, I just wish they could hang onto counsellors.. Oh, And one time they lost my records all together..now that was a hoot…good thing they kept a back up, it wasn’t up to date but enough to start it going again…thats what happens when you change counsellors so many times. They even hired civilain contractors at one time here in AZ.

  3. Nlck says:

    I am going on 40 yrs association with the USArmy Medical Department. Preparing and training for the combat experience. Now awaiting my retirement from civil service in pre/post deployment and mobdemob reference GWOT I feel compelled to comment on this issue. Although I was directly assigned to Infantry, Artillary, Aviation and Medical Combat Units, I never experience actual Down Range combat. I DID EXPERIENCE several near death experiences including my most recent traumatic Brain Injuries with accompanied 2 week coma.

    I was fortunate that I never required Mental Health Assistance thru my career, but was always a candidate due the multiple stress factors of a leader, a health care giver/provider, a follower, and colleague. I learned to cope well and retained my identification and assciation with my Airborne/Paratrooper past, and enlisted experience. Thus it wasn’t difficult to return as a MEDICAL PROVIDER aND SITE screener in support of GWOT, WTU, and as a TBI provider. To this I brought my understanding, experience and common sense. I was very successful in providing my service and gained trust from the soldiers, fellow care providers and referral providers. But along with the Stigma OF MENTAL HEALTH and resistance from the leadership of My self and fellow professional’s advise was seen as interference of the Mission. As time beganning or for me Vietnam Era. Medical Providers make recpommendations and Commander make decision of compliance. No one including myself ever wants a derrogative Mental Health comment made on their record, because it interfers with security, and reliability Surety. The medicaL REVIEWER MAKES THE FINDING BUT THE Mental Hygenist makes the CALL.

    No soldier except an Officer joins to be a lifer and they don’t want to be ID’d as a LIFER. Being in the military in the 70′s was all about association with the Good, facing your challenges and avoid the Bad influences. When I was groomed for Leadership as Enlisted I instilled and retained certain traits that have stayed with me
    1. Set the example
    2. Protect you patient.
    3. Communticate Right.
    4. Be pared to fall on your Sword.
    5. TACT.
    6. Loyalty.

    But my world is not perfect. Our soldiers are human, but until most recently they were treated as a line, paragraph in AR 40-501 chp 3, or denied help based on prior interpretation of pre WWII criteria for the VA.
    SOLDIERS who would finally seek assistance, tratment, couseling for a lifelong problem only to be denied association with the military and shut out by the VA.

  4. Dan says:

    I was a victim of “checking the block” while redeploying from Afghanistan. I started seeking help while overseas, which culminated in bottle of “happy pills”. While at the de-mob site, a few hundred of us were herded through a maze of stations so we could “check the box” and recieve a “GO” on our paperwork. Nobody wanted to say anything about any problems that we had, be it physical or mental. We were in Texas, back on U.S. soil, and were a plane ride away from seeing our families once again. Only the insane would say something then.

    Fast forward to home. I didn’t know how to adjust to my daughter who was now a young pre-schooler. She had become a little person, and not just a dependant. I didn’t know how to adjust to my wife either. I would stay up until the wee hours of the morning, making sure that some strange individual didn’t enter my house. I wouldn’t share feelings with her. I just thought of myself for the better part of a year or two. Then there was work. I happened to be employed as a federal technician at a National Guard installation doing pretty much the same thing I was doing overseas. I poured everything I had into work. I stayed late. I came in early. I even volunteered to come in on my days off. I was letting my family come second or third. After some time, there was a shift in my behavior. I bacame distant from work. My desire to succeed there was now dwindling. I became emotional with almost manic episodes. One moment cheery, the next in a rage, only to be followed with tears and helplessness. Finally, it got to the point that I believed that “nobody cared” and that nobody belived that I was having a tough time. I thought I would prove it to them. I was going to climb a radio tower, get onto the roof of the aircraft hanger, and do a swan dive onto the pavement just to prove that something wasn’t right. Luckily, I had a brief moment of sanity and admitted that I needed help. Now the story goes on and on. I wind up getting placed on the TDRL list from the Army (Temporary Disability Retirement List), and given a Disability Retirement from the Federal FERS system (Federal Employee Retirement System). I now go to school full time, adore my children, regained a loving relationship with my wife, and started to get my life back together again.

    This whole process from time of contemplating suicide to discharge/retirement was about 15 months.

    I was told by my psychiatrist at the VA that if I said anything to my boss and/or command that I would be kicked out. I replied that I couldn’t continue on the way I was, and if getting booted was what happened, so be it. I FINALLY took something into my own hands.

    I feel as though 80% of what happened could have been avoided if only a)there was a better screening process BEFORE returning home. Perhaps a mandatory meeting with counselors for everyone to identify possible issues, and to relay that on to a qualified medical person. b) If my command would have been more open to individual needs. I tried to tell them what was going on, and all it did was backfire. I was treated as an outcast, and as though I had some sort of communicable disease. The compassion for basic humanity was lost somewhere over the Atlantic Ocean. c) Follow up through the military with mandatory counselor meetings. If there is no problem, great. If there is though, perhaps some of the discharges and suicides would be reduced.

    While I was admitted to the local VA for psychiatric reasons, there were THREE other people from my battallion with me. Two were on the same deployment with me to Afghanistan, and one had been prior service Marines that spent a tour in Iraq. If that wasn’t a giant red flag, then I don’t know what was. The BN commander had a meeting with the VA staff about our prognosis and condition. That seemed to be another block that was “checked”. Nothing changed. Since my stay with the three others, I am the only one that has beaten the system. One person got fired from a $28/hour job and moved to NY. One never re-enlisted, and one got booted for failure to maintain weight and physical standards.

    I have a meeting tomorrow (9 Feb 2011) with the local VA OEF/OIF rep about how to present the disparity from what the posters say (Having a hard time, get help and ones like “It takes the courage of a warrior to say something is wrong.”) to what actually happens in the military (discrimination, discharge, being non-considered for promotion, revocation of normal duties). After this meeting, I plan on presenting this to the State Adjudant General (Major General – a two star). While I am out and have dealt with the gauntlet of depression mismanagement, there is another state unit in Iraq currently. I would hope that by me standing up and crying foul, that someone else will get the treatment they deserve.

    The practice of “checking the box” HAS to end.

    • SGT Laura Brooks, USMC 1999-2003 says:

      My husband and I both have a service-connected disability rating for PTSD…we refused to acknowledge any sign of weakness or instability while we were still in, but once we got out and tried to be “normal”, all total hell broke loose. THIS is the problem…PTSD hides. It lies in wait for months, or years and then-SURPRISE! It bites you right in the butt.No amount of post-deployment briefing can effectively catch PTSD in my opinion, because that is precisely the inherent nature of this beast. Time, and waiting. Veterans should be “checked on”, EVEN IF THEY NEVER APPLIED TO THEIR LOCAL VA, just in case. Every six months, or an annual thing–call, check, ask, reevaluate. SOMETHING. Some veterans don’t go NEAR a VA facility for fear of big government, of being held for observation, of being forced back in–anything you can imagine goes through our paranoid minds while PTSD is coming to the surface, and we remain untreated this way as well.
      I am only better today because of my meds, my psychotherapy and God Himself.

      • Gerald says:

        Hi, I am a Vietnam veteran, and I work with and for veterans from wwII to present day returning vets. I think the problem with a lot of vet who suffer with ptsd especially those from Korea, and Vietnam, they didn’t know what their problem was, they didn’t know why that couldn’t get close to people in personal relationships. Today ptsd is more in the forefront and it’s being discussed by the media and the VA and I thank them for it.

  5. brenhay@aol.com says:

    Dan,

    What a powerful personal statement of reality.

    I commend you for what you did for yourself and your family.

    I see your mission is not over; I wish you the very best and will keep you in my prayers.

    Truth needs to be told from the soldier’s perspective.

    I agree….”checking the box” HAS to end!

    Blessing to you and your family.

    BH
    Vetwife Advocate

  6. NavyOrdnanceman says:

    I couldn’t agree more. Even though my service in the Navy didn’t put me in any line of fire, the ex-wife who cheated on my while I was deployed led to many problems. If I would have been open about what was going on, I would have been labeled. Having a label would have lost my security clearance. Not being able to load the ordnance on those planes to be dropped on enemy targets would have broke my heart.
    Eventually when the ex-wife had to be sent back home, because the divorce was pending I couldn’t handle it. There were people to talk to, but they were just getting information out of me. It turned out after saying they were there to help, it was the opposite. I was discharged two weeks later because of the labels.

  7. First, thanks for your service. Next, I believe our society must change the perspective regarding suicide or we our going to have an increase of violent attacks and suicide. With that said, it will not be the soldier or veteran’s fault. Rather, the community will be the responsible persons.

    We have a problem in the USA and it is associated with “bullies” and criminal networks that rake advantage of people with psychological problems. If soldiers cannot turn to leadership, family, or veteran administration for assistance, they may turn to “cons” who con them into believing they can benefit them more than the government. Sadly, many of these criminal networks, sexual trafficking and meth trafficking included, do not care about the soldiers feelings. Rather, they desire them to use their training to negatively affect society.

    Before the latter happens, communities need to implement programs to “support”, “volunteer, and assist soldiers and veterans. I suggest “we the people” write the DOD and post commanders letters to emphasize a need to assure soldiers that they will not be punished for telling the truth. If a soldier is mentally unstable, they should seek assistance, and keep their position and responsibility. I believe the latter supplies “transparency” and data for supervisors. In addition, the soldier realizes they can be honest and take a break if needed. If their mental instability becomes omnipresent, they may have to be re assigned.

    Here are a few articles:

    Harding, Chris. Suicide: What is your keyword? Gather.com[online]. 2010. Available: http://www.gather.com/viewArticle.action?articleId=281474978542517

  8. I still believe that PTSD is the normal reaction to abnormal events that cause physical chemical changes in the brain. It is not a mental health disease but a mental health norm that needs adressing through conversation, decompression and medication. The longer you wait to to address it the longer it will cause problems. Combat units need to have decompression activities associated with the stress levels. Close or downrange combat is not a normal lifestyle for the human psyche any more than TBI. We need to address it as the norm for troops on multiple (or single) combat deployments.

    Civillian first responders have learned to de-brief and decompress following any major incident.

    Get with it!

    • Brent Otter, MA, SFC USA Ret says:

      It is now being called a mental wound – an accurate depiction. Critical incident debrief takes place informally by peers out in the battlefield, but warriors do not want to leave their fellow warriors short handed in a fire-fight. I agree this is a normal reaction to an abnormal event – combat.

    • M. A. Crow says:

      I have Complex PTSD from persistent childhood traumas and I couldn’t agree more about it being a simple human process. Dr. Robert Scaer has done some excellent work on traumatology lately, illustrating the very ordinary biochemical and psychological processes behind PTSD. The basics of what would help defuse PTSD and help people recover quickly should be being taught in middle school and high school, just like we’re taught to wash our hands to prevent disease or put pressure on a wound to stop the bleeding.

      Mental health is sorely neglected by this essentialist society that trumpets that the worthy never suffer. The opposite is so horribly true, and posts/comments like this are proof.

    • PANV says:

      Agree, Decompression or desensitivity, PTSD symptoms, signs and symptoms of depression/PTSD needs to be provided educated, discussed, debriefed to the soldiers as a manatory sit down and listen so every soldier can Act when the time comes. I don’t mean when the article 15 happens, or copurt martial, suicidal gestur or act or family discord and divorce. This should be done in Basic, AIT, PRE-Deployment and post-deployment, perferabily prior to state side , 2 weeks prior rtn to home station. This class should be required prior to each combaT TOUR. It’s not about weakness, it’s about understanding and communication. It should be offered to spouses. This type of class should be required, like POSH Traing, EO Training. PTSD/Depression awareness should be the enlisted responsibility and accountable from the CSM, 1SGT, Platoon SGT, Section/team LDR. Observed by the command and behavioral Health as a advisor and question/answer resource and laison for treatment options or triage. This should be done prior to SRC/SRP PROCESSING and everyone required one last Behavioral screening at SRC rather deployment, post, mob, or de-mob.

  9. Brent Otter, MA, SFC USA Ret says:

    Yes, this is a leadership failure. I’ll yell it so maybe the right person hears it – THIS IS A LEADERSHIP FAILURE. I served for 21+ years as an 11B, and now work as a mental health therapist. I know from being a soldier what a poor job the Army, and likely all the services, though I can’t speak to that, is doing with rehabilitating soldiers from mental wounds so they can safely re-deploy. If it were a broken leg, it would happen, so why not mental wounds? Leadership failure to create a climate and conditions (not cubicles to start with) that allow soldiers needing treatment to get it. There is no other solution than proper leadership fixing this. Any warrior know that.

  10. Norman Peacock says:

    Sometimes I ask myself,Does any one really Care??

  11. J Cline says:

    Oh for God’s sake… I’m an Army officer (16+ years, Major, prior enlisted, 2 combat tours) who’s about fed up with hearing this kind of false narrative. THE HELP IS THERE — but it’s the horse who won’t drink, and yet wants to complain about his thirst.

    I’ve been deployed and I wasn’t too stubborn to be honest when I got back — and it was fine. I’m not stigmatized, and never was. I told my Soldiers they’d be fools NOT to talk about what we’d seen, and if I, their commander, could admit I had trouble dealing with anger and dreams and insomnia, then it was safe for them to admit it, too.

    Yes, that’s right — I told my Soldiers I was in counseling. No, they didn’t respect me less in the morning. If anything, it made us tighter. And several of them did go seek help, which in no way lessened my regard for them.

    Look, Captain, if you have a problem (besides saying ignorant things about your service that no professional would say on a blog) then you too have options for talking about them, with no stigma or indeed no record of any kind to stain your precious career progression. For starters:

    1) Go find a MFLC. You know, the Military Family Life Consultants, the ones whose brochures are placed all over post. If you can’t find one at wherever you’re stationed (unlikely) then you can locate one via the MFLC website. They aren’t shrinks and they don’t dispense drugs, but if talking is what you need to do, then the MFLC is a good starting resource. If what’s going on with you is more than they can handle, they can get you linked with more serious therapeutic firepower.

    And by the way, the MFLC keeps NO records on you. Doesn’t report to your unit. Won’t pass on anything you say (unless it’s that you’re about to do harm to yourself or others — and that’s for your own good).

    2) Approach a Chaplain. You can worship God or trees or nothing, it doesn’t matter to them. All they see is someone hurting. Chaplains are confidential, they “get” the Army lifestyle, and they don’t keep records or report to your boss, either. Every battalion has a chaplain, so there should be no complaints about being able to find one.

    3) Tricare Online — Several TRICARE regions (including mine, TriWest) offer 24/7/365 online counseling by chat or by Skype. No referral needed, no cost to Tricare users, no records, no appointments. All you have to do is go to their website and look for the link.

    4) SAMHSA Veterans Suicide Prevention Hotline, if you’re that bad off. It’s actually a VA program, along with an online counselor chat service, here: http://www.suicidepreventionlifeline.org/Veterans/Default.aspx

    5) Real Warriors Live Chat, 866-966-1020, offers 24/7 availability of health resource consultants who can assist via phone, email, instant messaging, chat, even fax. A DoD level program run by the DCoE Outreach Center.

    6) Obviously — your medical providers. Again, confidential if you simply ask for help.

    I could go on; I’m just scratching the surface here. Bottom line is that your argument that being honest on your behavioral health evaluations — yes, folks, we do them before, during and 90 days after redeployment — would penalize you is simply… horseshit. You can be as confidential as you want to be. All they won’t stay silent on is a threat to harm.

    And Captain, you’d have to lie more than once, and to more than one counselor, before you’d get your “block” checked. You’d have to show some kind of serious pattern of behavior before the Army could (as in, be allowed to) give up on you.

    The only thing that’s keeping you or your Soldiers from getting care is ignorance and fear — which as a Soldier and a leader, I’d expect you to overcome. If you can’t face your fear and admit your issues honestly and candidly, how do you expect your troops to feel safe in doing so?

    You, and others like you, are part of the problem: all this self-pitying bitching about how you want the Army (and later VA) to “fix it”, but not willing to walk through any of the offered doors.

    Stop peddling some stigma myth — the Army could not make it easier or more private for you, but YOU’ve got to make the first move and SAY SOMETHING to SOMEONE.

    Until then, I’ll give you a block check, all right: Below Center of Mass.

    • Dan says:

      I would like to first suggest a point that you made in the first line. You are an officer. Despite what YOUR personal feelings are, along with the publicized rhetoric of the DOD, enlisted personnel are disposable commodities. I, probably among others, do not appreciate the unprofessional language that was exhibited, especially from a Senior OFFICER. It is that exact demeanor and knee jerk reaction that has others so afraid of taking a stand for themselves. I have personally waded through the seemingly endless parade of “care providers”. My first encounter was overseas where no counseling was offered. Just medication. I was told that the mental health clinic was being built, and wouldn’t be ready for months, and that the assigned counselors were on other FOBs, and they set thier own schedule. I have approached a Chaplain. Yes, they are there for a shoulder to lean on. However, they are not in a position to make desicions. They are in a capacity that can offer advice, assistance and make 3rd person recommendations. However, it is the Commander that has the final say.
      The “check ups” that you speak of are a farce. They are computer based questions that are to be done PRIOR to seeing someone, often at work as directed by the 1SG or PLT SGT.
      I agree that there are doors that can be entered for help if it is needed. It is the STIGMA that accompanies that help that stops people from getting help. So you are saying that if a soldier, say a SPC “fell apart” at work 4 months after returning, and requested to seek attention, that the command and other enlisted wouldn’t notice? That is the basis for a COMMAND requested FFD exam. Being a senior officer, you should know what a ususal FFD exam leads to. However, being part of the officer corps, most of this wouldn’t pertain to you anyway. You are privy to an indefinite term, and by the rank of O-4, have enough clout and rank that most wouldn’t have the gumption to say anything.
      Finally, in reference to your last line, “Until then, I’ll give you a block check, all right: Below Center of Mass” is TOTALLY INAPPROPRIATE. To even incinuate that your form of block checking is a bullet through the chest is appalling. Perhaps Major, you should take a look in the mirror and spend some time in a group with traumatized veterans. You just might have a different opinion to what really goes on outside the protection of the “O” ranks.

      • Rick Wheaton says:

        Dan ~ Well said!

        And to Major Cline ~ I’m surprised you haven’t yet been fragged while taking a dump with your attitude. As an O-4, I’m certain you “lead from the rear” and have no clue what you’re talking about. Please nurse below the beltline.

      • Brenda Hayes says:

        Dan,

        Again, another kudo!! Well said!

        If, Major Cline, is “real”; I would think that several of his PTSD symptoms are showing: A) being numbed out emotionally (to “others”) is showing. B) anger, perhaps misdirected anger.

        Maybe he is reaching out for “help”.

        The DOD/VA system has a long way to go before Soldiers/Veterans believe there will be no career repercussions. I can understand why active duty soldiers don’t reach out for help; not all Commands/Commanders are not proactive in this area and a lot probably have their own negative attitudes regarding MH issues.

        Also, for the Veteran and his Family members–Denial is not a river in Eqypt.

        Mental health still has a long way to go..its treatment as well as its acceptance.

        Several years ago there was a push not to use the term mental illness; but, to use the term neurobiological disorders. That push seemed to have disappeared. As stated previously, Culture change is difficult at best; whether it’s at the VA or any organization. And, it is especially hard for our Society in general.

        Stigma and its accompanying negative attitudes are still there; just like all of the “ISIMS” in our society.

        Major Cline statement contains just an example of how Mental Health attitudes continue “… to be a two step forward and a three step back for these disorders.

        Personally, I also have some qualms about those 2% that are “not affected” by War. I don’t think you can experience War without being affected somehow and/or someday.

        Our Society, including the Veteran Community, just needs to continue to communicate about these issues as well as put in place safeguards (with adequate consequences) in the DOD as well as in others areas. If the systems will not take these steps; then the active duty soldiers will have no reason to believe in the “rhetoric”.

        In addition, I don’t believe that most Americans realize that the ADA today still does not have the teeth it needs for these issues to be taken but so seriously.

        As well, I don’t believe that most Americans realize that the Department of Justice does not “prosecute” most discrimatory cases unless there is a systemic discrimation happening in public entities. I received that information directly from the DOJ hotline a few years ago!

        Not too long ago, I read about a movement that anyone who has a PTSD diagnosis should not be allowed to have guns; and even went as far as wanting to have the driver’s licenses stamped with their PTSD disability! That didn’t help the much needed dialogue either.

        The fine line needs to be debated in a healthy manner. It is NOT a black and white issue.

        Mental and Emotional Disabilities aren’t easy to deal with either as a “consumer” or as a member of society. Those who perceive themselves as not having any mental/emotional disorders continue to only see those Mental Health consumers who aren’t well stablized either by the correct medications or other alternative therapies.

        Yet, there are countless success stories of how these consumers can lead varying degrees of successful and quality lives. It might not be continuous and always linear; the “recovery” movement is placing more support and responsibility with the consumers themselves and SAMSHA has apparently stats to prove it!

        My understanding is this is why the Recovery Coordinators have been highly suggested at all VAMCs by VA’s Central Office. Highly suggested; But NOT mandatory leaves a lot of glitches regarding the actual presence as well as these Recovery Coordinators and its programs having measureable qualty outcomes; much less quality oversight.

        These programs should have been up and running with a 3 year Plan for over several years now. Who’s watching over these programs? Again, Veterans and their family members have only to look for answers to the VA’s Central Office.

        I had previously some time ago asked Alex and/or the VP team to get someone from the Recovery Coodinator’s office to put something at this blogsite. Most Veterans and family members have no clue what the RCs are supposed to be doing or that they are even there at their VAMCs. It’s pretty bad when the RC own colleagues or MH staff don’t know who they are or what they do!! I, again, just found this to be at the WPB VAMC as well as the Miami VAMC.

        So, again, it is the VA’s Central Office that is not getting the information from the people they are supposed to be serving with quality programs–the Veterans and their family members. Again, a systemic problematic issue of “Who’s Accountable? Who’s Responsible? If you want to know the TRUTH from the people its suppose to be serving; than put an Ombudsman Office in place that reports directly to General Shinsecki.

        Also on the topic of meds, I personally think our Veterans are on TOO many meds. (I think quite a few unfortunate stories have been told about this as well)

        I also take issue that they and/or their families (caretakers) have not been apprised of prescribed medication side effects that will show up now or in the future; (ie. suicides, early cataracts, liver damage, diabetes (Seroquel), impotence; mememory and cognitive issues, etc. (There are too many to list).

        In fact,a noted VA NY VAMC psychiatrist, Dr. Shay, has stated that our VN Vets should NOT be given diazopeines; and yet, I understand that this practice continues at the VAMCs.

        As well, I just read a study AND it was done in conjunction with the VA regarding how Veterans memories are affected by these meds.

        The VAMaC Drs aren’t letting their patients know about this as well (maybe they don’t know). And, there are no programs to assist the Veterans and family members who are dealing with these specific problems. I know, I’ve been trying for several years and continue to reach out and ask to no avail!

        If you have a documented diagnosis of a TBI (OEF/OIF) the PC Drs and/or other providers get it! If the Veteran does not have it; then they aren’t getting the help they deserve!

        Again, we need to continue an honest dialogue about these Neurobilogical issues including memory and cognitive disorders accompanying them as well as start to acknowledge them w/o a TBI diagnosis and put programs and support groups in place for the Veterans/Family members (caregivers).

        In fact, I’m STILL waiting–going on three weeks, I believe, for someone from DCOE to get back with me regarding this issue!! ANYONE LISTENING? or as Ziggie would say, “anyone else up there!”

        BH
        Vetwife Advocate

    • Matt Farwell says:

      Major,

      Let me get this cleared up. You have killed someone and then cashed the check uncle sam gave you to do it, right? And you’re fine. Congrats. You’re one of the 2% that LTC Dave Grossman wrote about in his book “On Killing.”

      Unless you’re not. I strongly suspect you’re a pogue whose most dramatic experience during a deployment was running out of ice cream in the DFAC. Care to post up the latest results of your command climate survey, since you’ve publicly tried to humiliate a fellow officer who is trying, still, to take care of Soldiers? Or would you prefer to email GEN.
      Chirelli and GEN. Ham, who have also both publicly spoken out about PTSD and tell them what crappy officers they are. Or just email me and tell me what a bad NCO I was.

      Matt Farwell
      (former Sergeant, US Army infantry)

    • Alexandria says:

      The suck it up and drive on philosophy of some military leaders is what prevents troops from honestly seeking help.
      There was a big stima when I was in if anyone even thought about seeking mental health services……no one wants the Commander in their business.
      As an enlisted member, I would not have felt comfortable about seeing a therapist who was an officer…..that is not an equal relationship to begin with. Now you add sharing your inner feelings with someone who you would have to salute. There is one base that had a whistler blower civilian therapist, who reported that the officers who were therapists were basically playing hard ass tackets with their clients. Basically telling them to suck it up, instead of truly seeking to help them.

      And to Major Cline–I am not sure what type of therapy you had, but it sure did not help you with empathy and understanding! Remember….not everyone is you.

  12. Norman Pickett says:

    I got my first VA disability rating for PTSD back in 1976. I went to college ROTC and upon commissioning in 1980 I had to sign a waiver of my disability and check the box that I was now fine for Army commissioning. Upon retirement then in 1992 I was evaluated for PTSD disability once again but this time for a much higher rating. Following 20 years of medications and group sessions with the VA I was no better but surviving. Eventually I discovered the PSDS organization on the internet and learned about their program for a Psychiatric Service dog. After about $4,000 spent to get and train my dog I am now enjoying the best time of my life. I am now helping to push for more PTSD veterans to get service animals and for the VA to grant recognition to this unique type of treatment for a better and more complete happier life.

  13. Matt Farwell says:

    This is an important message and one that needs to be heard. On my way back from Afghanistan (US army, infantry, 16 months) I completely checked the mental health block and…well, this is how it turned out: I was fine for a few months, went completely batty after a while and spent two different times in a psychiatric faciliy, and double that number for jail staysl. So…. Badly. If you link to the PBS article above, you’ll see an article on the second Rodeo in the VA Spa, which was certainly preferable to the time in the Naval Hospital.

  14. G.A. Wood says:

    Yes, Norman, there are many people who really care. I work daily with Veterans to help improve the many issues Veterans have to deal with from the experiences they have survived and are attempting to work through! I can only imagine your circumstances, you are not alone, not forgotten, and are cared about. The road you are on may be a difficult one but it is a road of recovery…a journey to your wellness. Continue on that path, reaching out to help where you may find it…it is there for you! God Bless you and keep your eye on the prize…your recovery. I will keep you in my prayers. George-Ann

  15. Dan says:

    I was just wondering….

    Do people that have the power, influence and/or position to change this disparity really read these posts, and if so, do they really care? I for one, would love to hear from someone that has the potential to make a difference from the top down. Perhaps someone beyond the scope of the “grass roots” struggle.

    It was just a thought…

  16. Meh says:

    Sir,

    You are completely correct on this issue. Military members for the most part will never admit to not being “okay” due to if they are not they are ridiculed, their promotions slow down….they are not accepted anymore among their peers… it is suicide to ask for help…Yes, We still need help.

    Thank you for your blog… keep it up.

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