DOD adds post-combat counseling session to diagnose long-term trauma
January 26, 2005
WASHINGTON — Troops returning from combat will undergo two mental health assessments — one right away, one three to five months later — to make sure they aren’t suffering long-term trauma, Department of Defense officials announced this week.
Servicemembers are already required to talk to counselors immediately before and after their deployment. But Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs, said often problems like post-traumatic stress disorder take weeks or months to manifest themselves.
“There is a minority percentage who have these issues, and we’ve also learned there is a concern or stigma about coming in for this,” he said. “One of the ways we think we can get at that is to require this to everybody.
“It’s really not meant to be a probing, intrusive kind of thing. It’s meant to be a ‘How are you doing? How is your family doing? If you’re having problems, we want to help.’”
Winkenwerder said having counselors re-examine everyone months after their return will identify more problems, which in turn will allow them to help more troops. Officials will also redesign the current pre- and postcombat interviews to include a stronger mental health focus.
“Many times just talking helps people deal with these issues,” he said. “Some people might be having symptoms and thinking, ‘Am I crazy?’ and they need to be told, ‘No, you’re having a psychological reaction to this stressful event.’”
The new program will begin sometime this spring. Winkenwerder said no cost estimates have been calculated for that redesign or the extra counseling.
Meanwhile, officials are wrestling with how to ensure everyone gets the new assessments, particularly Individual Ready Reservists, who don’t belong a specific unit once they’re demobilized, said Col. Thomas Burke, one of the Pentagon’s top psychiatrists and the director of mental health policy for the Defense Department.
Also problematic, he said, are active-duty troops who move to new units or leave the Army after they return from the combat zone.
The services have already been augmenting active-duty mental health providers with contractors, but officials know more help will likely be needed — both in the military clinics as well as at Veterans Administration hospitals, said Burke.
“Do we have enough doctors and facilities for what will be needed five years from now? I suspect not.”
Burke said, however, it’s too early to tell if the military medical system will be overloaded without a significant increase in providers.
While officials are paying close attention to the trends, he added, “we don’t know how long the war will last or how many troops will be involved.”
For now, Burke said, “we have enough psychiatrists, but they are all very busy.”
Winkenwerder said for now, troops who have already returned from deployment will not be included in the extra interviews. Family members also will not be included in the assessments.
But the department does plan to create hot lines for troops or family members to call for assistance and counseling, anonymously if they prefer.
Winkenwerder said the department estimates between 8 and 15 percent of combat veterans suffer some lasting mental health trauma from their experience. Information from the interviews will be kept in a confidential database, so officials can use what they learn to help other veterans in the future.
Department officials also announced this week a $13 million initiative to decrease smoking, binge drinking and obesity among servicemembers. The campaign will include online education programs and was launched after a 2002 study showed increases in those three areas among all of the services.
Stripes reporter Jon Anderson contributed to this report from the Pentagon.