Stressed soldiers: Army looking for answers

November 17, 2009
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Brass point to suicide-prevention study and resiliency training, but staffing and stigma pose sticky long-term problems
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Confronted by questions about the Fort Hood shootings, US Army officials downplayed the need for urgent new mental-health resources and programs, despite high stress levels and rising rates of suicide and domestic violence among Army personnel.

The recent shootings, in which an Army psychiatrist, Major Nidal Hasan, opened fire on unarmed troops in a deployment center, killing 13, have raised questions about the Army’s behavioral health programs. In the past two years, the Army has hired more than 900 additional mental health providers, while its TRICARE military health system has added more than 2,800. These resources supplement a group of some 400 Army psychiatrists who serve over 550,000 active-duty troops.

Asked about the adequacy of current Army mental-health programs, Secretary of the Army John McHugh stated in a news conference following the Ft. Hood tragedy, “Our problem is not so much a matter of having resources as it is of having answers. We have been trying hard to understand stress, to understand the causes of everything from domestic violence to suicides to other crimes among our personnel.”

McHugh cited a five-year study commissioned by the Army with the National Institute of Mental Health (NIMH). Launched in fall 2008, the study is surveying 90,000 active service members and 80,000 to 120,000 new Army recruits in the years 2009-11 for suicide-risk and protective factors, as well as details about suicidal ideations and attempts. Later, the study will also compare cases of individual soldier suicides against a control group of soldiers with similar demographic profiles. The goal is to create a suicide-prevention model similar to the disease-prevention model produced by the multi-generational Framingham heart-disease study, which started in 1948 and continues today.

While he added that the NIMH study allows for incremental release of “significant details,” McHugh acknowledged that the study is unlikely to have a significant short-term impact. Instead, he suggested that it could provide “the answers needed for us to apply [mental-health] resources in the most correct ways” over the longer term.

At the same news conference, General Casey pointed to the Army’s $125 million “Comprehensive Soldier Fitness” program as a working example of the Army’s efforts to improve the mental health of soldiers. Launched in the summer of 2009, the program has already trained some 300 Army noncoms—primarily platoon and drill sergeants—at the University of Pennsylvania. These “master resilience trainers” are to pass on resiliency training to current troops and new recruits. The Army’s goal is to place one such trainer in every Army battalion within one year.

In an earlier announcement describing resiliency training, Brig. Gen. Rhonda Cornum explained that resiliency is a way of thinking that helps prevent soldiers from falling into self-defeating traps. She added that soldiers need developed and resilient minds to put money problems, relationship issues, health issues, or tragedy on the battlefield into perspective, so they can continue effectively with their missions and lives.

"Resilience is a way of thinking. You apply optimistic thinking to a problem. In the face of setbacks, resilient people have the ability to think, ‘I'll do better next time.' It teaches you to remember that problems are temporary.” Some people naturally practice resilient thinking, Cornum added, while others must learn it.

The Army is also changing the ways in which it deals with more common mental disorders, such as depression. Under the theme, “One of the bravest acts . . . is to ask for help when you need it,” the Army’s medical command in October encouraged soldiers and their families to recognize and seek help for depression and other mental health disorders. By emphasizing the courage required to acknowledge a problem, the new theme is intended to help soldiers and their families overcome the stigma associated with receiving behavioral healthcare that pervades both military and civilian culture.

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