Marines sending mental health teams to Iraq

Mental health teams deploying to frontlines with Marines in Iraq


8:30 a.m. February 10, 2008

CAMP PENDLETON – Navy Chaplain Dick Pusateri has witnessed the stress of war on the faces of troops put in harm's way daily, in the strained relationships of families facing long deployments and the confessions of men shaken by the human cost of war.
For too long, chaplains were among the few people combat Marines felt they could turn to in a crisis.

The Navy and Marine Corps aim to change that by sending teams of mental health professionals to the frontlines this month, after studies showed a jump in the past five years in cases of combat-related mental health disorders, primarily post-traumatic stress disorder.

“Now is the time to adjust fire,” the generals wrote in a letter to the commandant. “We must shift the current direction of combat/operational stress control efforts to a more holistic, nested enabling strategy that provides a sound, unified approach.”

The Army adopted a similar approach last year, and has been deploying behavioral health specialists to patrol with its troops in Iraq and Afghanistan.

“What is probably new here is that we want to address it close on the frontlines, and thereby return people both back to combat and back to society healthy,” said Navy Capt. Mike Maddox, the 1st Marine Expeditionary Force surgeon.

The push to make the program permanent comes after a report by the Institute of Medicine found post traumatic stress disorder is the most commonly diagnosed mental disorder among veterans. It affected an estimated 13 percent of those returning from Iraq and 6 percent from Afghanistan.

Figures released by the Marine Corps show a fourfold increase in the number of Marines diagnosed with PTSD – from 394 in 2003 to 1,669 to 2006.

“If we identify a stress and if we can treat it close to the unit, it's less likely that person will be sent back, medivaced out of there,” said Cmdr. David Oliver, the 1st Marine Expeditionary Force psychiatrist.

click post title for the rest

This sounds like one of the best ways to address PTSD. So why do I read it with a lot of skepticism? Because there have been almost five years of reports like this. I hope they get it right this time and it's not just a publicity stunt some PR firm dreamed up to make them look like they care.



May 2007

Defense Department Releases Findings of Mental Health Assessment
By Sgt. Sara Wood, USA
American Forces Press Service


WASHINGTON, May 4, 2007 – The military has a robust system in place to deal with mental health issues, but longer and more frequent deployments are causing strain on servicemembers, a Defense Department study has found.

Navy Rear Adm. Richard Jeffries, medical officer of the Marine Corps, responds to a reporter's question during a May 4 Pentagon news briefing concerning the release of findings from the latest Mental Health Advisory Team survey. The survey -- the fourth conducted since 2003, assesses the mental health of deployed U.S. Army and Marine Corps troops in Iraq. Five top military doctors were on hand to explain details of the study.

The fourth Mental Health Advisory Team survey, MHAT IV as this survey was called, was conducted in August and September. For the first time, the survey included Marines in the study group. The MHAT was composed of behavioral health professionals who deployed to Iraq and surveyed soldiers, Marines, health care providers, and chaplains, Army Maj. Gen. Gale Pollock, the acting surgeon general of the Army, told reporters at the Pentagon.

The MHAT IV team found that not all soldiers and Marines deployed to Iraq are at equal risk for screening positive for a mental health symptom, and the level of combat is the main determining factor of a servicemember’s mental health status, Pollock said. For soldiers, deployment length and family separation were the top non-combat deployment issues, whereas Marines had fewer non-combat deployment issues, probably because of their shorter deployment periods, she said.
http://www.defenselink.mil/news/newsarticle.aspx?id=33055

Extended tours report from April 2007

Mental health worsens as deployments lengthen

By Kelly Kennedy - Staff writer
Posted : Thursday Apr 26, 2007 17:37:50 EDT

A recently released survey of soldiers and Marines puts concrete numbers behind problems experts have worried about since the wars in Iraq and Afghanistan began.

Suicides are up among combat vets, mental health issues are worse among those who deploy often and for longer periods, and one out of 10 service members surveyed said they have hit or kicked non-combatant Iraqis or destroyed their property.

Only half said they would report another service member for hurting or killing an Iraqi civilian.

The survey also comes with a recommendation from mental health workers that seems to fly in the face of the recently extended deployment lengths and troop surge: “Extend the interval between deployments to 18 to 36 months or decrease deployment length to allow time for soldiers [and] Marines to mentally re-set.”

The findings come from an April 18 briefing prepared for Marine Commandant Gen. James Conway by Mental Health Advisory Team IV, operating under the auspices of Multi-National Force-Iraq, a copy of which was obtained by Military Times. MHAT IV used anonymous surveys and focus groups to analyze morale, health and well-being, and the ethical issues of deployed U.S. troops.

Soldiers and Marines who have faced the most combat situations, deployed for longer periods of time, and deployed more than once face more mental health issues, according to a survey of 1,320 soldiers and 447 Marines. Of those on a second, third or fourth deployment, 27 percent screened positive for mental health issues, compared to 17 percent of first-time deployers. And 22 percent of those in-theater for six months or more screened positive for mental health issues, compared to 15 percent of those who had been there fewer than six months.
http://www.armytimes.com/news/2007/04/military_ptsd_survey_0426w/

The facts and time prove the Battlemind Training does not work

March, 2005
AMEDD Adapts To Needs Of Times
By Lt. Gen. Kevin C. Kiley, MC, USA

BY LT. GEN. KEVIN C. KILEY, MC, USA
Army Surgeon General
Commanding General, U.S. Army Medical Command


Today, our soldiers, families, health professionals and elected leaders are more aware of mental-health needs. We are committed to ensuring all returning veterans receive the physical and behavioral health services they require. More patients are seeking behavioral health support as we offer them more opportunities to solicit assistance.

Behavioral health researchers at Walter Reed Army Institute of Research have surveyed combat units and developed data regarding mental-health needs of soldiers before, during and after deployment to Iraq and Afghanistan. Last year they published findings in the Journal of the American Medical Association that accurately described mental-health status and noted improvements in the availability of mental-health services for soldiers during and after deployment.

It is critical that we help our soldiers prepare for war, and when they return from the war zones of the world we must help them ‘reset.’ To assist in this [area], researchers developed a comprehensive program, called ‘Battlemind Training,’ to train soldiers both pre- and post-deployment about what to expect at each phase of the deployment cycle, how to look out for the mental health of themselves and fellow unit members, and about the resources that are available for them to get help if they need it. Battlemind Training has been incorporated into the Army Deployment Cycle Support Program, and is given as part of the Post Deployment Health Reassessment (PDHRA) process.

One goal is to reduce the stigma long associated with mental health issues. Also, we must deal with the needs of families, as well as soldiers.

When a unit returned to Fort Lewis, Wash., last year, every soldier saw a psychologist, regardless of any reported mental health issues. Since everyone did it, it was seen as normal...no stigma. What’s more, Madigan Army Medical Center has implemented the Family Assessment for Maintaining Excellence (FAME) program, through which spouses of deployed solders are surveyed and, if needed, interviewed by mental health professionals.

At Tripler Army Medical Center, a new Soldier and Family Assistance Center provides easy access for mental health services under one ‘umbrella.’ Three new clinics were added for soldiers, children and adult family members.

One way to reach all soldiers, without stigma and with tight resources, is a new program we call ‘Respect-mil.’ Basically, family practitioners and physician assistants in our regular clinics will act as mental health counselors. With extra training and extra time to ask the right questions, our front-line medical force can screen most soldiers during routine visits.

http://www.usmedicine.com/column.cfm?columnID=248&issueID=72

And this was very interesting.
September 2007

Division Mental Health in the New Brigade Combat Team Structure: Part II. Redeployment and Postdeployment
Military Medicine, Sep 2007 by Warner, Christopher H, Breitbach, Jill E, Appenzeller, George N, Yates, Virginia, Et al

Objective: Recent Army transformation has led to significant changes in roles and demands for division mental health staff members. This article focuses on redeployment and postdeployment.

Methods: The postdeployment health assessment behavioral health screening and referral process and redeployment plan are reviewed, and data on postdeployment rates of negative events are reported.

Results: All soldiers and many of their families participated in an aggressive education program. Of the 19,500 soldiers screened, 2,170 (11.1%) were referred for behavioral health consultation; of those referred, 219 (10.1%) were found to be at moderate or high risk for mental health issues (1.1% of total screened). Of the moderate/high-risk soldiers, 146 (71.9%) accepted follow-up mental health treatment upon return to home station. Fewer cases of driving under the influence, positive drug screens, suicidal gestures/attempts, crimes, and acts of domestic violence were seen, in comparison with rates seen after an earlier deployment of this unit to Iraq. Conclusions: A formalized approach with command support and coordination can have a positive impact on successful referral and treatment and reduce negative postdeployment events.
http://findarticles.com/p/articles/mi_qa3912/is_200709/ai_n21033346

Battlemind has been a bust but they still use it. The numbers of suicides in Iraq have gone up as well as those who commit suicide when they come home. There have been suicides in Afghanistan as well. This does not even address any of the veterans who committed suicide after they were discharged by the DOD and before they were added to the VA records. With the numbers of troops coming back with PTSD they sure aren't preventing any of it either. Not that they could but if they addressed it as soon as trauma hit, they would have a better chance. That would mean they would have to have at least one mental health professional in every group going on patrol. They don't have enough to even come close to having one in every unit.

From Military Operational Medicine Reseach Program

Battlemind Training on New WRAIR-Psych Website
“Battlemind” is a Soldier’s inner strength to face adversity, fear, and hardship during combat with confidence and resolution; it is the will to persevere and win. Battlemind skills and strengths sustain the Soldier on the battlefield but if these skills and strengths are not adapted for the home environment problems can arise. Realistic transition training is critical to the mental health and well being of Soldiers, their units and families. New mental health tools for helping Soldiers transition through the different phases of their service careers are being made available on the Walter Reed Army Institute of Research Psychiatry and Neuroscience website (http://www.wrair-psych.org/).

Department of Applied Neurobiology
Mission: Conducts research on militarily relevant brain trauma resulting from ballistic, blast or neurotoxin exposures and identifies neuroprotection strategies. Research utilizes animal models (rodent and non-human primates), neurophysiology, neuropharmacology, behavioral protocols, and cellular and molecular biology techniques.
Current and future plans include

1) establish a prototype rapid triage and diagnostic tool for combat casualty care (CCC) (titled Biomarker Assessment for Neurotrauma Diagnosis and Improved Triage System; BANDITS),

2) test advanced development neuroprotection therapeutics in several experimental models of brain trauma,

3) investigate the role of cortical spreading depression as a mechanism of secondary injury following brain trauma,

4) study the mechanisms of penetrating ballistic brain injuries in a new rodent model,

5) test experimental therapeutics in limiting and preventing sequelae of silent brain seizures,

6) test neuropsychological consequences of chemical warfare nerve agent (CWNA) exposures and development countermeasures in rodents and non-human primates.

More…

Battlemind Training materials include brochures, briefings, instructor materials, and a video to aid Soldiers with the stresses and strains of initial entry, deployment, and returning home. Currently available materials and those in development can be used for Soldiers, Leaders, National Guard/Reserves, and families.

Soldier Battlemind
Leader Battlemind
Spouse Battlemind
Helping Professional Battlemind
Soldier PDHRA Battlemind Video
Additional Resources
Unit Needs Assessment Training Materials
Unit Behaviorial Health Needs Assessment Survey (UBHNAS)
Unit Needs Assessment Manual
Unit Needs Assessment Validation
Research Reports


The goal of this training is to develop a realistic preview, in the form of a briefing, of the stresses and strains of deployment on Soldiers. Four training briefs have been developed and are available for Soldiers, Leaders, National Guard/Reserves, and families.

(http://www.battlemind.org/)

http://www.momrp.org/battlemind_announce.htm

When will they notice this did not work?