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“We’re on a journey, and we’ve come a long way, … but we’ve got a long way to go,” said Army Col. Loree Sutton, chief of the newly created Defense Center of Excellence for Psychological Health and Traumatic Brain Injury. “That’s why we’re so thankful to teams like the RAND team that have stepped up and helped us better understand our challenges.”
Sutton called it “heartening” that the RAND report’s conclusions are “very consistent” with previous studies by the Army’s Mental Health Advisory Team and other results published in a private medical journal. “We appreciate their efforts to inform our efforts,” she added.
One of the study’s findings is that just more than half of servicemembers reporting symptoms actually seek care for post-traumatic stress disorder or major depression. For those who do seek help, only about half receive treatment that researchers consider “minimally adequate,” the report states.
“Clearly, that’s a finding that concerns us,” Sutton said.
“It’s very consistent with the civilian literature, as well as with our own assessment of the challenges in this area,” she said. She cited “closing the gap” between knowledge and practice as a top priority. “We will redouble our efforts,” she said.
Sutton said the military health community has used $500 million appropriated in 2007 to fund more than 25 major new programs supported by more than 125 initiatives, many of which “get to the heart of that concern.” She added, “We want to provide evidence-based care, the very highest quality care.”
One reason many troops avoid psychological treatment, the RAND report says, is because they fear it will harm their careers.
“In general, respondents were concerned that treatment would not be kept confidential and would constrain future job assignments and military-career advancement,” the report said.
Sutton said the military health community is attempting to transform military culture with regard to its approach to psychological care. Defense Secretary Robert M. Gates has bolstered these efforts, she said, by seeking to remove a question about health care history that appears on security clearance questionnaires.
“That’s in the process of being revised right now,” she said. “We think that that’s going to be a big step forward to help our servicemembers understand that seeking care, in fact, is a sign of strength.”
Joining Sutton at the roundtable was Air Force Lt. Col. Michael Jaffee, director of the Defense and Veterans Brain Injury Center. Jaffee said the “big cultural challenge” also occurs in the combat theater, especially in servicemembers’ attitude about seeking treatment for possible battlefield concussions.
“Our culture is so towards performance that we think we can shake it off; if we toughen up, we can get by it,” he said. “It's very similar to the professional athlete who may not want to be taken out of the game.
“So it really speaks to that big cultural challenge,” he said, “which is one of the main challenges in front of us.”
While the healthcare community has a long road ahead, it took a step in the right direction over the past year by hiring nearly 8,000 additional mental health professionals and other staffers, Sutton said.
The colonel also highlighted the Center of Excellence, a state-of-the-art hub for psychological health and traumatic brain injury treatment that opened its doors in November. One of her main duties there, she said, is to assess the efficacy of the more than 150 new programs and initiatives, increasing funding for those that are most efficient and scrapping those that flounder.
Underscoring a sense of urgency in her mission, Sutton stressed the need for “less talk and a lot more action” in regard to mental health clinical care, education, training, research funding, and outreach. She said spreading the importance of military mental health care is an issue of national importance.
“It's a national educational campaign,” she said. “Not just for those of us in the military and the veterans community, but for our entire country.”
