Posted on 01/25/2009 5:15:14 PM PST by DBCJR
In 2005, an Army captain in Iraq asked for a mental health evaluation for one of his soldiers, a private first class from North Carolina who was known to put the muzzle of his weapon in his mouth. The case was assigned to a psychologist who was unlicensed — a common practice in the early years of the war, when the Army rushed mental health counselors to the combat zone even if some weren't certified or fully qualified.
The psychologist reported that a screening indicated the 20-year-old private, Jason Scheuerman, was "capable of claiming mental illness" to manipulate his superiors and did not have a mental disorder. Three weeks later, Scheuerman stepped into a barracks closet and shot himself to death... His death, the subject of an internal Army investigation exposed to The Associated Press by his family, casts light on the armed forces' reliance on unlicensed counselors before the Army policy was changed to exclude them in 2006. ...
"There is a direct correlation between his actions and the events that led up to my son's death," Chris Scheuerman said, speaking of the unlicensed psychologist.
Historically, the Army deployed unlicensed psychologists under supervision until they were licensed, Col. Bruce E. Crow, the psychology consultant to the Army surgeon general, said in a statement to the AP. But by early 2005, "potential problems obtaining supervision in a combat zone" were identified, Crow said.
An Army spokesman, Lt. Col. George Wright, said 10 to 12 unlicensed psychologists were deployed to Iraq between March 2003 and May 2006, when the practice was stopped. He did not say what mechanisms were in place to ensure the unlicensed psychologists were supervised.
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(Excerpt) Read more at msnbc.msn.com ...
"Historically, the Army deployed unlicensed psychologists under supervision until they were licensed, Col. Bruce E. Crow, the psychology consultant to the Army surgeon general, said in a statement to the AP. But by early 2005, "potential problems obtaining supervision in a combat zone" were identified, Crow said."
The reader is lead to believe that the use of an unlicensed clinician is somehow unprecedented and that the level of care for our troops is somewhat less than what we receive as civilian citizens. The fact is that, in most community mental health centers and in many private practice clinics, supervised unlicensed clinicians are treating persons for mental illness. Everyday civilian citizens are evaluated and treated by unlicensed clinicians.
This practice is to provide supervision and practical experience for training new clinicians in the field. Supposedly, the supervision provides the safety net, which is arguable even in a civilian setting. However, in a combat setting, as this was, it is often not practical, possibly impossible. Practicum experience, i.e., supervised clinical experience, is a requirement of every clinical license. How else will unlicensed clinicians become licensed? To demand only licensed clinicians treat clients is to truncate the supply of new clinicians in an environment where the growth in demand for services is far outpacing the supply of those clinicians. This is particularly true in ramping up for a war.
The situation described here was in the context of the Army’s attempt to provide some sort of care in these circumstances versus calling chaplains “morale officers” (done in the early stages of this war) or letting soldiers go without care as in previous wars. The presence of this “psychologist” is tangible evidence of an Army attempting to improve care.
Any such improvement will experience such unfortunate incidents. We can find all too many incidents of clinical failures in the civilian systems of care. The massacre at Virginia Tech is one. One incident in a combat situation does not define a trend nor does it spotlight the quality of care provided by the Army. Certainly, such a critical incident commands the attention of any internal quality assurance and improvement system, whether civilian or military, stimulating internal mechanisms for corrective action. If a trend continues, external sources then need to demand answers. I am not sure that MSNBC has provided such a case of the negligence of the Army’s internal quality assurance and improvement system.
While this very tragic event is not something we should ignore, in war we have many casualties related to hurried ramping up and mobilization of massive forces and all sorts of preventable situations that are clearly seen in hindsight. Helicopters colliding, killing the crews and troops being transported, cases of friendly fire or ill-targeted air strikes, are all as tragic as Jason’s case. To say, “These things happen,” is beyond trite, but they are expected in the context of war. Outside the immediate loved ones of such casualties, no one feels the gravity of such tragedies more than the officers charged with their safety. Those managing our troops need to be afforded at least the same understanding that we give those managing mental health care in normal conditions.
While we should encourage care for our troops, we should also recognize that what happened here was a seam of transition in a process of bettering care. The real concern, in my opinion, is the care our troops get when they return. Each successive war has increased occurrence of mental health issues among veteran troops attempting to readjust to American life. Whatever the sociological reasons for that, we know that there is a trend of increasing incidence of mental illness following tours in combat zones. We need to adjust to that change.
MSNBC has overreacted, misunderstanding the management of mental health care and the particular challenges of improving care in combat situations. I would encourage advocacy in the area of care for veterans returning from combat, or even studying what sociological factors contribute to this trend, and determining how to better prepare our troops for the traumas of battle before going into combat. But the Army has made great progress toward mental health care in recent years, and we certainly should not hold them to a higher standard than what we hold community mental health centers locally.
MIT, Harvard, universities all have suicides. Maybe we should shut down the schools.
In the early 80’s, my HHQ company had two in a year or so. Both were profoundly unhappy people that drifted into the Army for I suppose distraction, order, hope for camaraderie, purpose. Unfortunately for them the enlisted barracks of wrench turning, moonshine drinking, constant bitching young males wasn’t a place of deep empathy. One of the discussions a hour or so after the event was who had the dibs on the single room the victim had. This was over breakfast.
I suppose the Army took a hit for taking in those two.
You don’t say?
I’m sympathetic to these poor souls, but I don’t conclude that it is the Army’s fault. This is liberal MSNBC exploiting people’s pain toward their agenda.
What coping skills did his parent's provide
him with while he was being raised ?
Good question. There is also the possibility that his depression was genetic, therefore more of a brain physiology thing. Neither are the Army’s fault. Perhaps there are better ways to screen these types out in recruitment.
http://www.behavioralhealth.army.mil/
http://www4.army.mil/ocpa/read.php?story_id_key=5798
http://www.armytimes.com/news/2008/03/military_mentalhealth_030708w/
You would have to look at the age/income/education vs the number of deaths. Maybe up it with a stress, work factor and see if it is above ‘normal’. Vaguely, I recall that the military is lower then the non military population, everything being equal.
I posted some Army websites on the subject if you are interested.
“Perhaps there are better ways to screen these types out in recruitment.”
Maybe, but the best system would still be an imperfect science. Honestly, how easily can we predict the actions of another? It is hard to predict our own actions. We can’t read minds. We don’t know who is faking, who is temporarily down, who is actually serious, and who is serious enough to go through with it.
The SF 32 is a 32 question survey that is 90+% accurate. The SF 16 is also above 90%.
Interesting. I have never heard of such a thing.
How do they figure that out?
20 guys come in, take the SF 32, get tracked, and 90% of those they predict will kill themselves actually do?
If so, what can they do to stop them? Besides basically detaining them forever?
Not that specific but they can detect tendencies toward depression.
Fair enough. I do think if we perceive a tendency towards depression in a person we should try to help out.
I just don’t think anyone should be held responsible for another’s suicide, unless they are really driving them to it in some discernible way.
Because our soldiers deal with extreme psychological stress in order to serve and protect us, the Military should be held ABOVE that of what we expect of the civilian world. We need to work to protect the men and women who protect us. The fact that it is common practice to use unlicensed theripists does not in any way make it okay for the Army to do the same thing.
Good info. Did you check out the Army websites I posted? They have a lot of current info.
Agreed
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