New Army regs vague on how to remove stigma of seeking help
December 11, 2009
THE DOCUMENTS:The new regulation: AR 600-63, “Army Health Promotion”The guidance:600-24, “Health Promotion, Risk Reduction and Suicide Prevention”
WASHINGTON — Earlier this year, a stateside Army unit issued a policy requiring soldiers deemed at risk of committing suicide to wear reflective vests with signs identifying them as troubled.
No Army regulation prohibited it. In fact, the Army offered little instruction for commanders on the stigma of seeking mental health care.
“The unit was trying to do the right thing and it had unintended consequences,” said Col. Chris Philbrick, deputy director of the Army’s Suicide Prevention Task Force.
New regulations and guidelines put into effect this fall after a wide-ranging four-month review by the suicide task force acknowledge stigma’s damaging effects. The Army for the first time has put on paper a formal policy regarding stigma, yet beyond prohibiting the singling out of soldiers using special clothes or markings, the regulations provide few specifics on how it should be carried out.
“It’s not prescriptive in that regard,” said Philbrick, adding the updates were more about “tightening up the message” and ensuring “everyone understands the standards.”
Commanders are simply directed to “create a command climate which emphasizes and encourages help-seeking behavior” and to “eliminate any policy which inadvertently discriminates, punishes, or discourages [soldiers] from receiving professional counseling.” It seeks to ensure soldiers “are not belittled, humiliated, or ostracized by other soldiers.”
To deal with both real and perceived stigma, the guidance tells leaders it requires “a deliberate and focused effort,” including “supporting confidentiality” of therapy and “reviewing policies and procedures that could preclude soldiers from receiving all necessary and available assistance.”
The regulations give some ideas for reducing inherent barriers to care, such as offering after-duty hours for behavioral health services and ensuring that installations offer preventative services, such as “depression and anxiety screening programs” and “targeted interventions aimed at high-risk populations.”
The Army has also opted to strike the phrase “mental health” in favor of “behavioral health.”
In addition to addressing stigma, the regulations also dictate that each installation will have a suicide prevention task force and mandate that an investigation is done on each suicide, regardless of whether the suicide happened off base.
Deployed unit commanders now have to provide suicide prevention training to soldiers before and after they take any leave.
“There were enough instances in the after-action review process that caused us to make adjustments,” Philbrick said about the change when asked if soldiers commit suicides in high rates at the time around their leave.
“We need to have leaders engaging soldiers and making sure they are continually aware and assessing their welfare,” Philbrick said. “The more you know the better able you are able to access what is different.”