Speaking to Congress as the military rushes to improve its much-criticized mental health system, S. Ward Casscells, assistant secretary of defense for health affairs, also acknowledged that the Army's touted plans to hire 25 percent additional mental health specialists may prove hard to fulfill for awhile because of problems in recruiting and retaining active-duty professionals.
"It's not easy to get people into the military," said Casscells, referring to plans by Army Surgeon Gen. Gail Pollock. "We cannot hire 200 Army psychiatrists, which Gen. Pollock wants to do, we can't do that overnight. So we need everyone to reach out and look out for service members."
"It might mean if your buddy in combat is staring off into space and not laughing anymore at the dumb jokes, maybe it's a sign they might need to go back to base, get three hot meals and to talk to someone confidentially," he added. "I don't expect we will have a perfect solution."
Casscells' comments came as the Pentagon and Congress are reviewing 95 recommendations made last month by a task force chaired by Navy Surgeon General Donald Arthur. Issuing an urgent warning, the panel found that more than one-third of troops and veterans currently suffer from problems such as traumatic brain injury and post-traumatic stress disorder and urged stronger leadership, more money and a fundamental shift in treatment to focus on prevention and screening.
"We would never blame someone who has broken a leg or got cancer, yet we will blame people who have a natural reaction to an incredibly stressful situation," said Arthur, who also testified Thursday before a House Armed Services subcommittee.
He cited soldiers who must walk down the streets of Fallujah each day with rifle in hand, knowing they could be gunned down at any time. "Much of this is a leadership situation. We need to have leaders to say, 'That was a frightening situation. I need to decompress.'"
Defense Secretary Robert Gates last month pledged to fix problems and ordered that a corrective plan be finished by mid-September. He is also supporting a plan that would do away with the practice of asking troops about previous mental health treatment when they apply for a security clearance.
About 38 percent of soldiers and 31 percent of Marines report psychological conditions such as brain injury and PTSD after returning from deployment. Among members of the National Guard, the figure is much higher — 49 percent — with numbers expected to grow because of repeated and extended deployments.
On Thursday, Casscells said his team was still analyzing the recommendations and formulating policy proposals for Gates to review. But he indicated a need for greater privacy, including possibly shielding reports of mental health discussions that service members have from line commanders.
In the meantime, the Army has launched an extensive educational program on the stigma attached to mental health problems to determine whether it can be expanded to the other armed services.