Support our mission

ARLINGTON, Va. — Troops surveyed after serving in Iraq and Afghanistan have indicated that the stigma of seeking counseling would keep them from doing so, said the two authors of an Army battle-stress study.

“The most important finding are the barriers to care,” said co-author Army Col. Charles Hoge, chief of Psychiatry and Behavioral Science at the Walter Reed Army Institute of Research.

“Soldiers and Marines with mental health [issues] don’t receive help because of the stigma.”

Such a stigma isn’t anything new, acknowledged the other co-principal investigator, Lt. Col. Carl Castro.

“Are the findings surprising? Not really. We know, for example, that combat … impacts soldiers. We know that from previous wars. We know there is a cultural barrier and a stigma” to seeking treatment.

But for the first time, the study puts a number to the fact, he said.

“This allows us to quantify the problem, to characterize what we are trying to address. And now, when we implement new programs, policies and procedures, we will have the numbers to assess whether they are working.

“The whole reason we’re conducting the study is to address this issue. We know we’re not perfect. The Army is a learning organization. We know there is a culture of stigma to mental health, and we need to find out exactly what those barriers are and what we can do as an organization to reduce or eliminate them.”

The military services have several initiatives to counter perceived barriers, some related to the study and some started independently to address problems of post traumatic stress disorder, depression, suicides and other mental health concerns, Castro said.

“One of the things we’re doing is we’re using training and education, telling the soldiers what they might experience and what to expect” on the battlefield, said Castro, who also was one of 12 mental health experts who visited Iraq and Kuwait last summer and fall.

Part of their task included investigating suicides in the field. Last year, there were 26 self-inflicted deaths in Iraq and Kuwait between April and December, with 24 in the Army and two in the Marine Corps.

Troops indicated that receiving pre-deployment education and training made them more likely to both seek out mental help, and to comfort a fellow soldiers, Castro said.

The Pentagon’s health system also is boosting the number of mental health counselors and social workers at primary care facilities, embedding mental health providers on the battlefield so troops don’t have to leave their units to get treatment, and conducting mandatory post-deployment health assessments, which include a mental health evaluation, though they are not anonymous.

The DOD-wide program Military One Source lets members receive six free and confidential sessions with a civilian provider off-post, and thus outside of the military system and a member’s chain of command, Castro said.

The programs are less than a year old and officials have no research data on its use or effectiveness as of yet, he said.

In order to keep the service confidential, participants are issued an identification number. Those needing more than the six sessions must be brought back into the military medical system, he said.

Web sites are service specific:,, and

Overseas, people can call the following numbers for information:

• In Europe, the number is 00-800-4648-1077.

• In Japan, if using phone company ITJ, the number is 0041-800-46481077. For IDC, the prefix is 0061; KDD, the prefix is 001, and NTT, the prefix is 0033.

• In South Korea, the DSN number is 550-Army (550-2769) or commercial 001-800 46481077.

Stripes in 7

around the web

Sign Up for Daily Headlines

Sign-up to receive a daily email of today’s top military news stories from Stars and Stripes and top news outlets from around the world.

Sign up