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Cuts could affect Army's mental health providers, limit soldiers' access to care

A soldier from the 4th Infantry Brigade Combat Team, 3rd Infantry Division, completes a survey designed to determine his attitudes and opinions about mental health treatment, Aug. 17, 2012 on Fort Stewart, Ga.

WASHINGTON — The Army could lose a large chunk of its mental health force to furloughs starting next month, limiting access to care for soldiers dealing with post-traumatic stress disorder and other issues.

Although the Surgeon General’s office is looking at ways to exempt some personnel from the sequestration fallout, “right now the plan is that our [Department of the Army] civilians who are employed with us will be impacted across the board,” Col. Rebecca Porter, chief of behavioral health for the surgeon general, told defense reporters Tuesday at a breakfast roundtable.

More than half of the Army’s 4,500 mental health professionals are civilian. Contractors are exempt from furloughs, but those civilians employed directly by the Army are subject to the cuts imposed by sequestration. About 251,000 Army civilians will have to take 22 days of unpaid leave from April 26 to Sept. 30.

“It’s not the quality of the care that we expect to be impacted but the availability and access to it in a timely manner,” Porter said.

That’s something the Army already struggles with. Wait times for mental health providers have been a significant problem at installations across the service, leading the Army to double the number of mental health providers in the last five years – and the service is still understaffed.

Last month Army Chief of Staff Gen. Ray Odierno told Congress that sequestration means the Army will have to decrease its number of mental health providers, reversing the service’s concerted hiring efforts.

Porter said to mitigate the impact of sequestration and maintain access to care, Army Surgeon General Lt. Gen. Patricia D. Horoho has prioritized behavioral health, along with wounded warrior care, primary care and the disability evaluation system.

Porter said her office is approaching sequestration in a “measured and deliberate way,” analyzing usage data to aim cuts at less busy facilities and exploring the option of temporarily assigning uniformed providers to fill in at the affected facilities.

Civilians play a key role in the Army’s mental health programs. One of the service’s newest initiatives is to embed providers directly with brigades. Each battalion has its own provider based with them, who is familiar with the commanders, noncommissioned officers and training cycle of the unit. That kind of close proximity of care proved successful in a pilot program at Fort Carson, and the concept is set to be service wide by fiscal year 2016, Porter said.

Those embedded teams are made up of almost entirely civilians, Porter said.

The Army has worked for years to attract more mental health professionals to the service, but that effort could be undermined in the long term should shaky job security led the new recruits to look elsewhere.

“If they start to go out the door, it will take us a lot longer to rebuild that force than it does for them to leak away,” Porter said.

The Army has nothing to offer as incentive to stay, such as retention bonuses that were once available. Instead, Porter said, it’s just an appeal that “we’ll do everything we can to support you.”

mccloskey.megan@stripes.com
Twitter: @MegMcCloskey
 

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