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Lt. Justin D’Arienzo is the at-sea psychologist for the USS Kitty Hawk Strike Group.
Lt. Justin D’Arienzo is the at-sea psychologist for the USS Kitty Hawk Strike Group. (Allison Batdorff / S&S)

YOKOSUKA NAVAL BASE, Japan — In terms of adjusting to change, boot camp is big.

But life aboard a forward-deployed aircraft carrier in Japan requires an even bigger stretch — in Lt. Justin D’Arienzo’s professional opinion.

“I see a lot of young sailors fresh out of boot camp … and while boot camp is a big adjustment, being on an aircraft carrier overseas is even bigger,” said the USS Kitty Hawk psychologist Friday.

So, what stresses out sailors?

“Romance and finance — a lot of it comes down to that,” D’Arienzo said, explaining that relationship issues, marital stress, financial problems and on-the-job stress are common threads in the problems he sees — which is similar to the civilian world.

Also, the occurrence of problems is similar to that of the civilian population, he said. He expects 10 percent to 20 percent of sailors to need mental health services at any time, with about 1 percent requiring emergent care.

What’s different is that being on a ship means there’s no escape from personal problems, no privacy and the sailors’ support network can be miles or months away, he said.

D’Arienzo is the go-to psychologist for thousands of sailors in the carrier’s strike group, with more than 5,000 on the Kitty Hawk alone.

On the ship, adjustment disorders are most common, with panic disorders and mild to moderate depression rounding out the top three, he said.

Most of these can be cured with some form of psychotherapy, D’Arienzo said. He, in conjunction with a physician, can prescribe medications, although the ship’s pharmacy formulary is limited, he said.

Also different from the civilian sector are the consequences for mental illness, as being diagnosed with recurrent major depression, psychosis, or bipolar disorder mean a medical separation from the Navy.

Sailors usually can serve with other mental illnesses, provided they can function in their jobs, though they may be restricted from certain tasks or access, D’Arienzo said.

Sailors also can get in trouble for faking an illness to get out of work, D’Arienzo said.

“I see that pretty often. They often see me when they want to get out of the service,” D’Arienzo said. “They pretend they want to hurt themselves.”

But, while not being too specific — D’Arienzo wants to keep his investigatory tricks to himself — he has been trained to differentiate between real illness and fakery.

He ends up administratively separating about one or two people a month, he said.

“You don’t want to keep chronic malingerers around too long — they end up being a drain on the system,” D’Arienzo said. “There are also legitimate people who are not cut out for the service but don’t know that until they end up in an arduous assignment like Kitty Hawk, or working in the FDNF (Forward Deployed Naval Forces).”

The Navy added psychologists to its aircraft carriers in 1998 as a way to prevent expensive medevacs for psychological cases, D’Arienzo said.

Psychologists aboard can determine the need for medical evacuations as well as provide other services, such as substance abuse programs at sea.

D’Arienzo wrote a column in Yokosuka’s base newspaper called “Mindgames” and wants to start a base television show devoted to questions such as “What is ADHD and should you medicate?” as well as tools to cope with long deployments, he said. He also teaches “Psychology 101” aboard the ship, he said.

There are plenty of positions open for Navy psychologists. A recent DOD Task Force on Mental Health report cited in American Psychological Association magazine, vacancies are at nearly 30 percent, with only 87 active–duty psychologists.

For D’Arienzo, this means the doctor is always in. Sailors are flown off their ships and submarines to see him on the carrier, or meet him in ports, he said. Because he has such a large client base, spread out over miles of ocean, D’Arienzo said he also enlists the help of chaplains and independent duty corpsmen whenever possible.

“It’s the nature of the job,” D’Arienzo said. “I try to consult as much as I can.”

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