Public Policy Update

In June, the U.S. House of Representatives took the first steps toward creating a new federally funded psychology training program, the Defense Graduate Psychology Education (D-GPE) Program. Similar to the Bureau of Health Professions' Graduate Psychology Education (GPE) Program, the proposed D-GPE program will support the training of military and civilian psychologists to meet the rapidly increasing mental health needs of U.S. soldiers and their families, as documented in several recent government-issued reports.

Rep. C.W. Bill Young (R-Fla.), chairman of the House Defense Appropriations Subcommittee, has allocated $4 million to establish the D-GPE program in the fiscal year 2006 House Defense Appropriations Bill. The GPE program is funded out of the Labor, Health and Human Services, Education Appropriations Subcommittee.

"This action demonstrates Young's continued commitment to psychology education and training, as well as his recognition that soldiers returning from recent overseas deployment--and their families--are often in great need of psychological services," says Cynthia Belar, PhD, APA's executive director for education. Although the House has approved the bill, the measure still must be accepted by the Senate during the House-Senate Conference Committee deliberations. APA's Education Public Policy Office (PPO) is optimistic that the funding will be awarded.

The D-GPE Program was developed by the APA Education Directorate in consultation with several of the nation's leading military psychologists, including Maj. M. Victoria Ingram, PsyD, Col. Bruce Crow, PsyD, Lt. Col. Rick Campise, PhD, Lt. Col. James Favret, PhD, and Cmdr. Morgan Sammons, PhD. APA-accredited psychology training programs in the Air Force, Army and Navy are eligible to receive D-GPE funding. The program's goal is to increase the quality and quantity of psychological services in the nation's military hospitals.

Specifically, D-GPE grants will support training in military psychology doctoral internships and postdoctoral programs. Under consideration is a program that would create a Triservice Center of Excellence as the primary training hub for psychologists, interns, residents and postdoctoral fellows using internationally renowned civilian experts. If the D-GPE program is approved by the Senate, the funds will flow through Fort Detrick in Frederick, Md., to the Henry M. Jackson Foundation for the Advancement of Military Medicine. Ingram, the director of residency training at Walter Reed Army Medical Center in Washington, D.C., will complete the required application for releasing the funds from Fort Detrick, in collaboration with her colleagues at other military hospitals. Then the Henry M. Jackson Foundation, based in Rockville, Md., will distribute the funds.

Meeting soldiers' needs

For many U.S. soldiers, the fighting does not end on the battlefield. A July 2004 New England Journal of Medicine study (Vol. 1, No. 351, pages 13-22) estimates that one in six soldiers returning from Iraq and one in nine soldiers returning from Afghanistan report symptoms consistent with major depression, generalized anxiety or post-traumatic stress disorder (PTSD). Consequently, military medical facilities are facing a potential deluge of tens of thousands of returning military personnel coping with disabilities and re-adjustment issues.

The D-GPE program will help facilities address this increased need plus prepare civilian psychologists to better meet community needs.

Soldiers may experience such PTSD symptoms as clinical depression, hypervigilance, insomnia, emotional numbing, recurring nightmares and intrusive thoughts. In many cases, these symptoms worsen over time and can lead to alcohol and drug abuse, unemployment, homelessness and suicide. A February report by the U.S. Government Accountability Office shows that if soldiers do not have access to PTSD services on returning from Iraq or Afghanistan, the chance for early identification and treatment--which can lessen the severity of the symptoms and improve their quality of life after combat--may be missed.

In an effort to avoid cases of advanced PTSD, psychologists are now serving in battlefield units, focused on prevention strategies and techniques to help soldiers deal with issues before they become serious and incapacitating. There are currently six Iraq Combat Stress Control Teams made up of psychologists and other mental health providers.

The majority of the service members treated on the front lines by psychologists are able to return to active duty within a few days, according to military psychologist Lt. Col. Kathy Platoni, PsyD, who noted in a June 14 Washington Post article: "Our main purpose is to help people get back to the field, and we get more than 90 percent of them back out so they can do their jobs."

In addition to treating PTSD, psychologists trained through the D-GPE program will be able to address a range of other psychological problems. For example, they can teach coping skills to soldiers with serious injuries, such as amputation or disfigurement.

Psychologists will also help veterans and their families adjust to changes in their lives caused by traumatic brain injury (TBI). TBI symptoms include memory loss, difficulty with attention and reasoning, headaches, confusion, anxiety, irritability and depression. As widely reported, TBI rates have increased significantly since the start of the war in Iraq. A July 2004 San Francisco Chronicle survey of troops being processed through Walter Reed Army Medical Hospital indicated that TBI affects as many as two-thirds of all soldiers wounded in Iraq.

Military psychologists can make a difference

Military men and women often return home to struggles with depression, substance abuse, social withdrawal and unemployment. APA policy officials believe the D-GPE program will do much to address these and other serious problems faced by returning soldiers who remain in the military and will also help to successfully reintegrate those who leave the military for civilian life.

APA's Education PPO looks forward to working further with Chairman Young, the Henry M. Jackson Foundation and military psychologists to implement the new D-GPE program.

Further Reading

For more information on this or other Education Directorate legislative initiatives, visit tha APA Education Web site.

Amanda Ring is the legislative assistant in APA's Education Public Policy Office.