Marines react to mental health furloughs

By THOMAS BRENNAN | The Daily News, Jacksonville, N.C. | Published: July 15, 2013

Recent furloughs of behavioral and mental health staff have left some local Marines questioning the quality and frequency of care they will receive on base.

“The days I go into therapy are an absolute blessing,” said Cpl. Eric Smith, a Camp Lejeune Marine. “Now, with the furloughs in effect I’ll need to wait longer for that same blessing to come. ...Congress and the Department of Defense need to take into consideration the aftermath created by war and do the right thing on our behalf.

“They need to ensure they are taking care of the men and women of the armed forces who are suffering from the mental ramifications brought on by war.”

Due to sequestration, furloughs that affected a variety of civil service employees including behavioral and mental health providers began last week. The mental health directorate of Naval Hospital Camp Lejeune sees more than 1,500 patients between civil service employees, active duty service members and contract employees. Prior to the furloughs civil service employees accounted for 425 of those appointments. Now they will only be able to render 365.

“My provider is a civilian facing furlough,” Smith said. “Before the furloughs she wanted to see me once every 10 days, but that couldn’t happen because of her patient load. Now the furlough is just going to push my treatment days even further apart.”

Smith, who suffered a Traumatic Brain Injury during one of his two deployments to Afghanistan, was diagnosed with post traumatic stress disorder and major depressive disorder in 2010.

Smith compared a cognitive therapy group he attends to Alcoholics Anonymous but for service members suffering from PTSD — and says it has been the most therapeutic treatment he has been afforded.

“I’m not nervous about what will happen to me with these furloughs — I’m over the hump in treatment,” Smith said. “I’m worried about the one’s just starting out. They’re the one’s we need to watch out for.”

Clay Gentry, also a Camp Lejeune Marine, was wounded in Afghanistan in 2010 when he suffered both shrapnel wounds and a traumatic brain injury. Gentry was medically evacuated to the United States where he was immediately referred to physical therapy and mental health treatment by the Naval Hospital.

“The care has been very good,” Gentry said. “It’s very on par with what I need and I have absolutely no complaints. ...But our appointments are already spread out enough as it is. These furloughs are going to push them out even more and that’s going to have very negative effects.”

The memory problems associated with a TBI make life very difficult sometimes, making routines very important for patients like him, Gentry said.

“This is going to truly affect my days and my quality of life from day to day,” Gentry said. “On a scale of one to 10 with 10 being the worst, this is going to be about a six or worse for patients.”

Navy Capt. David Lane, the commanding officer of Naval Hospital Camp Lejeune, acknowledges that wait times may get worse for patients during the furloughs.

“We’ve done a lot to mitigate the current situation, but it’s still a less than ideal situation,” said Lane.

Clinical and administrative meetings have been modified and the mental health department is consolidating training, which in turn will offer more time to ensuring patient care remains a priority, said Lane.

For wounded Marines and sailors returning from Afghanistan early due to injuries, the Welcome Back Medical Evacuation Program will remain in place ensuring that a continuum of care is established immediately upon their return, serving as a safety net for wounded warriors in the remain behind elements, Lane said.

“It ensures they aren’t lost in the mix of Marines and sailors coming and going from deployment,” Lane said. “...We get them an immediate physical or mental evaluation even if it’s in the middle of the night and then we establish appointments for them to go to.”

The mental health providers are determined to make things work throughout the furloughs, said Sawsan Ghurani, the director of mental health for Naval Hospital Camp Lejeune. However, Ghurani said, wait times may increase: Patients used to being seen every five days may find themselves being seen every seven or 10 days.

Patients who are in the “stable phase” of their treatment may receive shorter appointment times, therefore allowing providers to direct care to those who need it most. In the interim there are different therapy options such as group, yoga, art, recreational or spirituality, Ghurani said.

“As time progresses, the impact of the furlough will become more clear and we will reassess what our team is doing,” Ghurani said. “...We will never turn a Marine or sailor away if they need help. We will do everything we can to ensure our quality of care is not compromised.”