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Kevlar for the mind: Services need to redefine commitment to behavioral health

May. 3, 2012 - 03:35PM   |   Last Updated: May. 3, 2012 - 03:35PM  |  
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In my last column, I talked about the findings from a survey about the stigma associated with seeking behavioral health care. The survey was conducted within Army Special Operations Command and reported in the April-June 2012 issue of Special Warfare magazine.

The report first identified several primary factors associated with stigma and barriers to care, including confidentiality, accessibility of care, perceived abuse of the system, command climate, and fears of being labeled or suffering damage to a career.

The second half of the report, which I'd like to talk about in this column, provides thoughtful recommendations for overcoming, or at least reducing, stigma associated with behavioral health care. The ones most relevant to the military at large:

Sickness-to-health model. The field of psychology is moving away from a pathology- or sickness-based view of behavioral health to one of health and resilience. This is clearly seen in sports psychology, where athletes are trained to focus on strengths instead of weaknesses. It's also a component of training for elite military forces, where focus is on performance enhancement and proactive methods for preventing illness — psychological or physical.

Embedded behavioral health staff. Embedding a behavioral health professional in a spec ops unit is not a new concept. However, it is relatively new for the Army and, to a lesser extent, other services. The Army is seeking to embed behavioral health teams in its units in the belief that this will reduce stigma, increase access to care, and allow commanders to use behavioral health providers as internal consultants.

Coordination with chaplains. It's not uncommon for a service member to opt for consultation with a member of the clergy as opposed to a mental health worker. Consulting with chaplains is often seen as less stigmatizing, more confidential, and a better personal fit for some, particularly those with a spiritual background.

Diversity of services. In line with the previous recommendation, providing access to an array of services is an important way to ensure troops get care. In addition to traditional behavioral health providers and chaplains, troops can seek assistance through Military OneSource, Tricare network providers (with some limitations), and other various programs at bases and posts across the military.

The Army Special Operations Command survey highlights the importance of addressing this issue at all levels of leadership. Without support from the top, dysfunctional cultural beliefs about behavioral health care will remain.

Bret A. Moore is a clinical psychologist who served in Iraq and is the author of "Wheels Down: Adjusting to Life after Deployment." Email kevlarforthemind@militarytimes.com">kevlarforthemind@militarytimes.com. Names and identifying details will be kept confidential. This column is for informational purposes only. Readers should see a mental health professional or physician for mental health problems.

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