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UndertreatedMentalHealthAilmentsinMilitaryPersonnel

MelanieDavis
NURS412

ThishealthpolicybriefisintendedfortheSeniorEnlistedAdvisorfortheDefenseHealth
Agency(DHA).TheDHAsupportsdeliveryofhighqualityhealthservicestomilitaryand
beneficiaries.
Summary
TheUSmilitaryhasdeployedmorethan2millionmilitaryservicememberstoIraqand
Afghanistanoverthepast14years,(Lee,2015).Thesecombatzonesaredifficultareasandare
bothmentallyandphysicallydraining.Asmembersreturnfromtheseareasofconflict,they
arentreceivingthementalhealthevaluationsortreatmentneeded.Asofnow,anymentalhealth
treatmentthesemilitarymembersreceiveisbasedontheanswerstheyprovideona
questionnaire(Lee,2015).
Asseeninaresearchstudy,militarymembersoftendonotdisclose
theirmentalhealthconcernsorpsychologicalstresstheyarefacing(Dobscha&Denneson,
2015).
Improvementstoaccuratelyassessthementalhealthofreturningservicemembers
continuouslyneedtobemade,aswellasestablishingscreeningmeasuresthatarenotsolely
reliantuponselfreport(Dobscha&Denneson,2015).
Background
Mentalhealthdisordersareprevalentamongmilitarymembers,especiallythosewhohave
deployedtositesofcombat(
Hoge,Grossman,Auchterlonie,Riviere,Milliken,Wilk,2014).
Mentalhealthissuescanarisefromhavingtoendurethehorrificconditionsandexposuretothe
harshelementsandeventsthatoccurintheseareasofconflict.
Whiletheseconditionsput
militarymembersatriskandvulnerabletodevelopmentalhealthdisorders,manymilitary
memberswhocouldusethehelparentscreenedappropriatelyoraccurately.

Onestudyfoundthatmentalhealthproblemsinmilitarymembersoftengountreated
(Brown,
Creel,Engel,Herrell,andHoge,2011)
.Duringthisstudy,577participantsthathadreturned
fromcombatscreenedpositiveforposttraumaticstressdisorder(PTSD),depression,or
generalizedanxietydisorder3monthsafterreturningfromIraq(Brownetal.,2011).Over
wereawaretheyhadaproblem,butonly40%werewillingtoreceivementalhealthcare.This
studyrepresentsacalltoactiontovalidateinterventionstoimprovetreatmentengagementand
retention
(Dobscha&Denneson,2015)
.
Barrierstosuccessfulimplementationofmentalhealthtreatmentandinitiation
Militarymembersreturningfromcombatandareasofconflict,consistentlydonotdisclosetheir
truementalhealthstate(Hogeetal.,2014)forreasonsincluding:negativeperceptionsofunit
stigmawereassociatedwithreceivingMHcare,concernsaboutlosingjoborsecurityclearance,
concernswithconfidentiality,andunprofessionalbehaviorofprovider.
Additionalstudiesneedtobeperformedonthecorrelationbetweenthestigmasurrounding
mentalhealthcare,interestinobtainingMHcare,andactualcareutilizedtodeterminewhether
thebiastowardmentalhealthcanbemodifiedwithadjustmentsinthedeliveryofMH
care(Brownetal.,2011).
Recommendations
Increasedawarenessandrecognitionofsupport,orlackofsupport,significantstressors,
unaddressedorundertreatedcareneeds,andanyotherwarningsignsofdistressthat
couldbeconsistentwithmentalhealthillness,needstobefurtherevaluatedbyamental
healthspecialist.

Militarymembersreturningfromdeploymentandareasofconflictshouldbepersonally
screenedbyMHspecialists,notonlybytheirPCP.
Discontinuethequestionnairemembersarecurrentlyrequiredtofillout,asitisnota
veryreliablescreeningtoolasmembersdontalwaysadmittohavingmentalhealth
difficulties.
Mentalhealthconcernsofmilitarymembersreturningfromdeploymentsites,continuestobea
substantialGovernmentalissuethatcontinuallyneedsimprovementtowhereMHneedsinthe
militaryareexceptionallymet.Tohaveeverymemberthatreturnsfromdeploymentbeseenbya
MHspecialistisarealisticgoal,andcanbeexecuted.Everymilitarymemberisscreenedpriorto
deploying,therefore,everymembercanandshouldbescreenedformentalhealthissuesupon
return.

References
BrownM.,CreelA.,EngelC.,HerrellR.,HogeC.(2011).Factorsassociatedwithinterestin
receivinghelpformentalhealthproblemsincombatveteransreturningfromdeployment
toIraq.
JournalOfNervousAndMentalDisease,199,
797801.
http://dx.doi.org.ezproxy.library.wwu.edu/10.1097/NMD.0b013e31822fc9bf
Dobscha,S.,Denneson,L.(2015).InteractionswithVHAcarepriortosuicide:Implicationsfor
providers.
VAHSR&DCyberseminar
.
HogeC.,GrossmanS.,AuchterlonieJ.,RiviereL.,MillikenC.,WilkJ.(2014).PTSDtreatment
forsoldiersaftercombatdeployment:Lowutilizationofmentalhealthcareandreasons
fordropout.
PsychiatricServices,65,
9971004.
http://dx.doi.org.ezproxy.library.wwu.edu/10.1176/appi.ps.201300307
Lee,D.,Warner,C.,Hoge,C.(2015).
PosttraumaticStressDisorderandRelatedDiseasesin
CombatVeterans
.
PosttraumaticstressdisorderscreeningintheUSmilitaryandVA
populations.

ElspethCameronRitchie
.(pp1326).SpringerInternationalPublishing.

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