Thousands strain
http://www.usatoday.com/news/military/2010-08-23-1Aforthood23_CV_N.htm
By Gregg Zoroya,
FORT HOOD, Texas — Nine months after an Army psychiatrist was charged with fatally shooting 13 soldiers and wounding 30, the nation's largest Army post can measure the toll of war in the more than 10,000 mental health evaluations, referrals or therapy sessions held every month.
About every fourth soldier here, where 48,000 troops and their families are based, has been in counseling during the past year, according to the service's medical statistics. And the number of soldiers seeking help for combat stress, substance abuse, broken marriages or other emotional problems keeps increasing.
A common refrain by the Army's vice chief of staff, Gen. Peter Chiarelli, is that far more soldiers suffer mental health issues than the Army anticipated. Nowhere is this more evident than at
Counselors are booked. The 12-bed inpatient psychiatric ward is full more often than not. Overflow patient-soldiers are sent to private local clinics that stay open for 10 hours a day, six days a week to meet the demand.
"We are full to the brim," says Col. Steve Braverman, commander of the
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That doesn't even count those soldiers reluctant to seek care because they are ashamed to admit they need help or the hundreds who find therapy outside the Army medical system, Braverman and other medical officials say.
Officials worry the problems may worsen — for the military and the country.
"If Fort Hood is representative of the Army — and 10% of the Army is assigned to Fort Hood — then if you follow the logic, our numbers should be scalable to any other post in the country," says acting base commander Maj. Gen. William Grimsley.
"I worry that if we don't see this through the right way over the long haul ... we're going to grow a generation of people 10 or 15 years from now who are going to be a burden on our own society," he says. "And that's not a good thing for the Army. That's not a good thing for the
Statistics provided to
•
•Last year, 2,445 soldiers were diagnosed with post-traumatic stress disorder (PTSD), up from 310 in 2004.
•Every month, an average of 585 soldiers are sent to nearby private clinics contracted through the Pentagon's TRICARE health system because Army counselors cannot handle more patients. That is up from 15 per month in 2004.
•Hundreds more see therapists "off the network" because they want their psychological problems kept secret from the Army. A free clinic in
•Last year, 6,000 soldiers here were on anti-depressant medications and an additional 1,400 received anti-psychotic drugs.
"I don't think we fully understand the total effect of nine years of continuous conflict on a force this size," Chiarelli says, reacting to those statistics.
"Those numbers are pretty staggering," says Kathy Beasley, a health care executive with the Military Officers Association of
Every time more counselors are hired here, their schedules immediately fill up with patients. "It's almost like a Field of Dreams," Braverman says, referring to the famous line from the 1989 film about a baseball field on an Iowa farm that spontaneously draws crowds. "If you build it, they will come."
'Life can slowly slip away'
Staff Sgt. Josh Rivera came back from his third tour in
"When a soldier is constantly gone and actually fighting, not just deploying and sitting in an office, life can slowly slip away," says Rivera, 32, a native of the
IN
Thirty-nine cumulative months of war had left him distant from his family and confused about his role in their lives, Rivera says. All that made sense was the infantry, which he loves. Rivera resisted seeing a counselor until his marriage was in real trouble, he says.
The Army therapist who met with Rivera and his wife, Julie, gently guided them back to basics — what brought them together 10 years before, why each mattered to the other and what they wanted out of life, the couple say.
Chaplains provide marriage counseling, but for soldiers who want to see a licensed marriage counselor, the base's social work department has two, each with a caseload of 60 couples, says Lt. Col. Nancy Ruffin, department director.
She has to refer some troubled marriages to private clinics, and not all the soldiers are willing to do that, Ruffin says.
The demand for other types of counseling also far exceeds supply. There are not enough social workers to treat soldiers suffering the emotional effect of sexual assault. Ruffin says she has one social worker, who is handling 50 cases.
The child and adolescent psychiatric services at
Because of war and deployments, not only are there more soldiers suffering emotional problems, they are sicker than ever and require more counseling sessions, Phillips says. Even after the latest round of hiring, Phillips says, a recent internal analysis showed the mental health staff will need an additional 58 counselors to meet the demand.
Suicides outpacing 2009
Despite the increase in mental health resources, there have been 14 confirmed or suspected suicides among
Army Sgt. Douglas Hale Jr., 26, was one of the most recent
On July, 6, Glenda Moss received this text message from Hale, her son: "i love u mom im so sorry i hope u and the family and god can forgive me."
Her son had tried to kill himself in May. She feared he might try again. She immediately called the Army and then drove the 90 minutes from her home in King,
It was too late. Hale had walked into a restaurant across Highway 190 from Fort Hood, asked to use the bathroom, locked the door and shot himself in the head with a newly purchased handgun, according to a police report. He was removed from life support a few days later.
Moss knew her son was very troubled. When his second combat tour to
He was brought back to
The Army sent him to a psychiatric hospital in
A statement released by
Base officials declined to discuss the specifics of Hale's case while an Army investigation continues.
Moss says her son seemed to be in good spirits after leaving the
Moss says the Army can do more to watch over troubled soldiers like her son. "They need to do as much as they can to stop this, because if they don't, the Army's going to be responsible for a lot more (suicides)," she says. "I don't want another family to have to deal with what I went through.
'Stigma was still a problem'
After the mass killings in November,
One in four said they would be viewed as weak, treated differently or harm their careers if they admitted suffering emotional issues, says Col. William Rabena, who led the campaign. The attitude was particularly strong among majors, lieutenant colonels and full colonels.
"Stigma was still a problem," Rabena says.
For those soldiers afraid to seek help, who decline to go to Army therapists or private clinics that contract with the military, there are alternatives.
A Pentagon program offers soldiers a limited number of counseling sessions with private therapists that will remain off their medical records. The program is called Military OneSource, and it provides up to 12 free and confidential therapy sessions when soldiers call a toll-free hotline. From May 2009 to May 2010, there was a 72% increase in sessions provided by the program in the
Another option for
The five therapists at the project are booked solid, says the director, Maxine Trent, a psychotherapist and the wife of a retired Navy SEAL.
The clinic has seen 7,117 soldiers, spouses and their children since it opened in 2008, says Matthew Wright, a director with Scott & White Healthcare of
Soldiers, many of them officers, come into the clinic seeking therapy for the first time in their careers,
"Generally, you have the parade rest," she says, demonstrating how they sit with backs straight, arms outstretched and palms on knees. The tension in their bodies, she says, is palpable.
"Those who have been back-to-back deployed vibrate. ... There's different energy. There's hyper-vigilance that you won't see anywhere else,"
When her offices opened,
Even this program struggles to cope with all those needing help and getting the money to pay for it.
A $750,000 grant from the
Adam Borah, who runs the outpatient psychiatric clinic at Fort Hood, sees progress in the many soldiers stepping forward to seek help. "The bad news is that there are a lot of people out there who need behavioral heath care," he says.
Braverman worries that if the number of patients keeps climbing, soldiers will give up waiting to see someone and avoid seeking help. Private clinics that contract with the military to handle overflow patients are overworked, says Chuck Lauer, a senior administrator at
Staff Sgt. Rivera, who got the marital help, worries for the soldiers. "The military needs to know that they are losing very good soldiers and squads and platoons to multiple deployments," he says. "The amount of help needed is actually overwhelming."
Copyright 2010 USA TODAY, a division of Gannett Co. Inc.
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"The master class has always declared the wars; the subject class has always fought the battles. The master class has had all to gain and nothing to lose, while the subject class has had nothing to gain and everything to lose--especially their lives." Eugene Victor Debs
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