February 25, 2007
Psychological Needs of Military Personnel and Their Families are Increasing — Straining Military Health Care System, Reports APA Task Force
Serious barriers to mental health care exist due to shortage of providers, reduced access to care and stigma of seeking services
WASHINGTON — A report of the American Psychological Association (APA) released today calls attention to the increasing mental health needs of military personnel and their families — needs that are straining the current military health services system. Many service personnel and their family members are going without mental health care because of the limited availability of such care and the barriers to accessing care.
The report, developed by an APA Presidential Task Force on Military Deployment Services for Youth, Families and Service Members, notes that while service delivery efforts by individual military mental health providers are laudable, the military system falls short in its ability to meet the psychological health needs of deployed personnel and their families.
The APA Task Force examined several studies and surveys of military personnel completed over the last four years to determine the effect of military deployments on service members and their families (spouses, children and significant others), the significant barriers to receiving mental health care from the Department of Defense (DoD) and the Veterans Affairs (VA) system, and the availability and effectiveness of current programs. The Task Force was further charged with creating recommendations to improve the delivery of mental health services to deployed personnel, those returning from a combat zone, and military families.
"Deployment can be a complex, and for some families, overwhelming process," states Michelle D. Sherman, PhD, co-chair of the APA Task Force. "Deployment means extended separations and the uncertainty of having a loved one in a combat zone. The situation creates an environment in which the development of significant emotional problems for military personnel and their families is a real possibility."
According to the APA Report, a growing number of military personnel and their families are reporting emotional problems resulting from deployment stress. More than 30 percent of all soldiers met the criteria for a mental disorder but less than half (23-40%) of those with mental health concerns sought help. Moreover, these figures do not include those who don't identify concerns or those who develop symptoms after returning from deployments.
Stress can be more severe for both military personnel and their families when certain risk factors exist, according to the report. Families with a history of problems, young families experiencing their first military separation or families who recently moved to a new duty station are more vulnerable to the stresses of deployment. Additionally, families with foreign-born spouses, service members without a unit affiliation or those serving in the National Guard or Reserves are more likely to experience higher stress levels.
Serious barriers to accessing quality mental health care for military personnel and their families are prevalent, the report found. The shortage of psychologists (close to 40% vacancy) in active duty slots hampers the availability of treatment. This shortage has increased stress and diminished morale among the providers remaining within the military care system. The increased job stress for these providers is leading to high attrition rates and creating an overflow of referrals to civilian psychologists who may not have as much training as military psychologists on issues related to the military and deployment.
Reduced access to care due to long waiting lists, limited clinic hours, breakdowns in the referral process and hard-to-reach locations also make it difficult for returning military personnel and their family members to get help, cites the report. The problems range from maintaining mental health care for service members who are transitioning from active duty to veteran status, to finding health services for National Guard and Reserve personnel who live far from military bases.
Further, according to the report, stigma and negative attitudes within the military about obtaining mental health treatment often prevent those in need of care from seeking it.
Children of military families are also dealing with the effects of deployment. Currently, 700,000 children in the U.S. have at least one parent deployed overseas for military duty. Having a primary caretaker in a war zone can be one of the most stressful events a child can experience, states the report.
The APA makes the following recommendations:
- Establish centralized leadership of military mental health services to better coordinate the services on military bases and surrounding communities.
- Educate military leadership about the importance of mental health care among service members and their families and about reducing stigma associated with seeking mental health services.
- Undertake more research on mental health issues related to deployment to guide policies, program development and treatment plans for service members and their families.
- Ensure that treatment is available to service members and their families throughout the deployment cycle with special focus on posttraumatic stress disorder (PTSD) and traumatic brain injuries (TBI).
- Increase recruitment efforts to hire more psychologists and to retain well-trained and experienced psychologists.
- Provide special ongoing training in deployment stress for all psychologists in the military system - both military and civilian providers.
- Allocate additional funding to ensure access to high quality mental health care for service members and their families.
Presidential Task Force on Military Deployment Services for Youth, Families and Service Members: Chair: Shannon J. Johnson, PhD, Naval Medical Center, San Diego, CA; Co-Chair: Michelle D. Sherman, PhD, Oklahoma City Veterans Affairs Medical Center ; Jeanne S. Hoffman, PhD, Tripler Army Medical Center; Larry C. James, PhD, Tripler Army Medical Center; Patti L. Johnson, PhD, Madigan Army Medical Center; John E. Lochman, PhD, ABPP University of Alabama; Thomas N. Magee, PhD, Offut AFB ; David Riggs, PhD, Uniformed Services University of the Health Sciences
The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 145,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting health, education and human welfare.