Amid recurring reports of a mental health crisis among American service members comes another disappointing systematic review of the military's psychiatric policies. Despite recent stories noting the somewhat improved outlooks of our soldiers in Iraq and a very gradual dissolution of military taboos regarding treatment, a thorough policy overview reveals that the degree of attention paid to the mental health of outgoing soldiers is nowhere near satisfactory.
In response to last week's Army report confirming, in the soldiers' own words, that levels of depression and anxiety are on the rise and that repeated deployments and staff shortages leave many unable to seek mental health treatment, officials admitted that the military does not currently employ enough specialists to provide the needed services. Interestingly, the current ratio of mental health providers to active soldiers is far lower now than in 2004, and the numbers have most likely been exacerbated by the length of the current conflict. Military spokesmen went so far as to suggest hiring civilian psychiatrists to work near the front lines of current combat zones. The military has repeatedly confirmed in public statements that they understand the depth of the current problem and the toll that mental health issues take on the efficiency of each affected soldier. But newly released internal data implies that they've yet to take sufficient action to improve their mental health services and that the American public has almost certainly not heard the last of this issue.
The crucial issue raised by this most recent report concerns not the treatment of soldiers currently serving overseas but the screening process administered to prospective servicemen and women who are scheduled to depart for Iraq and Afghanistan. The equation is simple: if the military wants to counter charges of unsatisfactory mental health policy, it should probably start by assuring, through a more thorough vetting procedure, that problematic individuals do not serve overseas in the armed forces in the first place. But the numbers are hardly flattering. Fewer than 1% of the soldiers sent to war in 2007 received any sort of referral to a mental health professional, even though several independent military studies have estimated that at least 10% of the soldiers awaiting deployment qualify for some sort of diagnosis and/or treatment. According to army surveys, "9.6 percent had a diagnosis or a drug prescription indicating a mental health problem in the year before they were sent to war." This percentage, of course, does not include the individuals with undiagnosed conditions. Their number could be even higher.
The issue has been raised before. A series of 2006 news stories focussed on soldiers who were clearly not fit to serve but received deployments despite their obvious mental health problems. The military responded to public sentiment by raising the number of screened soldiers to 2.4% for a period of two months before it fell, again, to its standard rate: less than 1 in 100. The basic concern is, in fact, more than a decade old. In response to a perceived need for greater mental health assessments, the military added a yes-or-no mental health question to their general health questionnaire in 1997. But only 1 in 10 of the soldiers who answer in the affirmative currently receive referrals, and the vast majority of that sub-sample are still declared fit for service.
The military's desire to avoid unneccessary expenditures is understandable given the scope of current engagements and their limited sources of funding. But turning an effective blind eye to such a pervasive problem is unacceptable. We can't ignore the fact that the most recent troop survey revealed slightly higher levels of morale than reported one year ago and that fewer soldiers now believe that seeking treatment for mental health problems will endanger their careers. This is good news. Still, improvements in the political spectrum and tactical gains on the ground do not negate the damaged minds that continue to emerge from Iraq and Afghanistan in need of treatment. And the problem, as we've said before, will grow far larger before receding from the public eye. The cases themselves will live on as the mental health status of our veterans plays a role in American political discourse for decades to come. In order to avoid a larger future scandal, the military should be forced to more effectively follow up on its promises. We need a better mental health screening system, and any delay on the matter is excessive.
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