Uncategorized — 07 April 2014

Killeen, Texas: The shooting rampage at Fort Hood has  once again focused attention on the military’s mental-health system, which,  despite improvement efforts, has struggled to address a tide of psychological  problems brought on by more than a decade of war.

Military leaders have tried to understand and deal with mounting troop  suicides, worrying psychological disorders among returning soldiers, and violent  incidents on military installations such as the one that left four people dead  and more than 16 injured at the Army post in Texas on Wednesday.

But experts say problems persist. A nationwide shortage of mental-health  providers has made it difficult for the military to hire enough psychiatrists  and counsellors. The technology and science for reliably identifying people at  risk of doing harm to themselves or others are lacking.bigstock-Mental-Health-Warning--32532146

Officials have yet to identify a motive behind the actions of the Fort Hood  shooter, Army Specialist Ivan Lopez, who took his own life. But they have said  he was taking medications for anxiety and depression.

Lopez had reported sustaining a traumatic brain injury and was being screened  for post-traumatic stress disorder, which is thought to affect as many as 20 per  cent of veterans of recent wars. None of Lopez’s known issues suggest he was at  risk for committing violence, and military leaders have said there were no  warning signs.

Lieutenant General Mark Milley, the commanding general at Fort Hood, said on  Friday that an examination of Lopez’s record showed no combat injuries or  contact with the enemy. He said an argument was a “direct, precipitating  factor” leading to the shooting.

Experts stress that the mentally ill are more likely to be the victims of  violence rather than the perpetrators and that American society, not just the  military, struggles with how to handle mental illness.

Although Lopez sought treatment for his depression and anxiety, there remains  in the military a stigma that prevents soldiers from seeking the help they need,  said Barbara Van Dahlen, president of Give an Hour, a non-profit group that  connects troops and their families with free mental-health services.

“The military is reliant on self, focused on the other, mission first, stop  whining, suck it up,” Van Dahlen said. ”It’s only in the last 10 years that the  military, to its credit, started to think about, OK, we had better focus on  taking care of our mental-health needs or we are going to be in trouble.”

Growing alarm about suicides and violence within the military has prompted  unprecedented efforts to beef up systems to help soldiers cope with multiple  deployments and adjust to life after war.  The Army has launched the  largest-ever study of mental-health risk and resilience among military  personnel, and set up a $US65 million facility dedicated to treating traumatic  brain injury, post-traumatic stress disorder and other psychological  problems.

The military also has started deploying psychiatrists and counsellors to  serve alongside soldiers in war zones and conducts therapy sessions for returned  soldiers and their families.

Despite these efforts, there have been hundreds of active-duty suicides since  2011, according to figures from the Army and non-profit groups.

Some advocates believe the military lacks adequate funding to identify and  treat mental issues and that many of the diagnostic tools available are outdated  and inadequate.

For example, post-traumatic stress disorder is diagnosed using a list of  questions.

“Imagine going to your doctor because you think you have a broken leg and  your doctor asks 20 questions,” said retired General  Peter Chiarelli, a  former Army vice chief of staff. “And then your doctor says, ‘You don’t have a  broken leg. You can go home.’ You’d say, ‘Aren’t you going to X-ray my leg?’  That’s how we diagnose PTS.”

The military, he said, needed to fund research aimed at developing more  advanced tools, including brain-imaging scans and blood tests.

General  Chiarelli also said the military’s efforts to hire more  clinicians to diagnose and treat post-traumatic stress had been impeded by an  overall national shortage. That, in turn, has led to an over-reliance on  prescription drugs instead of more time-consuming treatments.

Nonetheless, some Army officials say, the resources provided at installations  such as Fort Hood are quite substantial. But the demand for them is high. Fort  Hood, and the Darnall Army Medical Centre there, provides psychiatrists,  psychologists and family-life chaplains to help people with anxiety, depression  and post-traumatic stress.

“Could we use more? There’s always a need for more, especially after 12 years  at war,” said a mental health professional at Fort Hood.

This article first appeared on the Sydney Morning Herald on 7 April, 2014.



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