Military Mental Health Issues to Receive Special Focus

Military mental health is not just for military mental health care clinicians anymore. “Over 40 percent of the deployed troops were from the National Guard or Reserves,” said Navy Captain Paul Hammer, M.C., director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury in Arlington, Va. “Once they get out of the military only half will receive care from the VA or the military health system. So there will be a huge number of people appearing elsewhere in the civilian medical system.”

Hammer will join other military and civilian psychiatrists to present a special military track at APA’s annual meeting in Philadelphia in May. The sessions will examine the expected mental health needs of the 2.25 million American service members who served in Iraq and Afghanistan over the last decade.

“It’s important to partner with civilian providers and institutions to offer the care for veterans,” said Hammer in an interview. “Civilian clinicians should be attuned to asking about patients’ military experience.”

Attendees can hear quite literally from the front lines of military psychiatry. Maj. Jerald Block, M.C., is a Department of Veterans Affairs psychiatrist from Portland, Ore., who joined the Army Reserve and was eventually assigned to Iraq and Afghanistan. Block will talk about his personal experience in a war zone and about issues facing military psychiatrists, such as deciding whether to evacuate soldiers with mental health problems or keep them in theater.

Another psychiatrist, Chris Nelson, M.D., will discuss his experience at Camp Lejeune, N.C. Nelson remained a civilian but now works as a contractor at the Marine Corps base.

Other sessions will address advances in screening and therapy for posttraumatic stress disorder (PTSD). These will feature experienced Army psychiatrists such as Col. Christopher Warner, M.C., deputy commander for clinical services, U.S. Army Medical Department Activity, Alaska, and Col. David Benedek, M.C., a professor of psychiatry and deputy chair of the Department of Psychiatry at the Uniformed Services University of the Health Sciences.

Hammer will preside over another discussion of PTSD, a complex condition often viewed in simplistic terms by the public.

“Psychiatrists and other mental health providers know that PTSD is a very complex entity,” said Hammer. “So it’s important to communicate about co-occurring issues, like subthreshold symptoms of sleep disturbance, depression, and substance use.”

Former Army psychiatrist Elspeth Cameron Ritchie, M.D., M.P.H., now chief clinical officer in the District of Columbia’s Department of Mental Health, will oversee a panel addressing possible mechanisms of action for increasingly popular alternative and complementary therapies.

In a recent report, U.S. Army Gen. Peter Chiarelli spoke of “soldiers and families still suffering from the effects of deployment and combat-related wounds, injuries, and illnesses. …” The military track sessions at APA’s annual meeting will seek to explore and expand ways to alleviate the suffering those individuals endure, said Ritchie.