"If an individual checks nothing, (or) I have no mental health issues, they're not necessarily being sent to mental health counseling," said Army Surgeon General Kevin Kiley, speaking at a hearing on military medical readiness before the House Defense Appropriations Subcommittee.
It is estimated that about 17 percent of returning war fighters have post-traumatic stress disorder or severe anxiety and depression, compared with about 6 percent or 7 percent of the general population, Kiley said.
Studies show some troops fear being stigmatized if they acknowledge they have problems such as nightmares, hyper vigilance or anxiety. Or, some want to spend time with their families instead of getting mental health help.
To help catch them, Navy Surgeon General Donald Arthur said some of the mental health screening has been delayed a couple of months so that troops can first spend time with their families.
Kiley said the amount of face-to-face counseling of returning troops is increasing, and those who seek help are getting it. In recent years, the military has implemented programs that encourage troops to seek mental help if they need it.
Subcommittee Chairman John Murtha, D-Pa., asked if shortening deployment lengths could help. Many troops spend more than a year deployed in a war zone.
Arthur said deployment length and the effect it has on a soldier's health is under review, but the consensus is that the effect varies with the intensity of the deployment.
"If you are on the front lines going door to door in Fallujah ... perhaps three months is an appropriate time," Arthur said. "If you are in Kuwait or Djibouti as many of our folks are, then perhaps a year is all right, so we're trying to tailor those deployment lengths to the length of the threat."
Charles Marmar, chief of staff for mental health at the San Francisco VA Medical Center, recommended that federal money be used to develop a brain screening that would help identify when a returning soldier potentially has mental health issues.
After the hearing, Murtha said he supports that recommendation. While things have improved, it will be a long time before the stigma in the military associated with seeking mental health help goes away, said Murtha, a decorated Vietnam war veteran and retired Marine colonel.
For troops today, "unless you want to be helped, they aren't going to get help is what it amounts to," Murtha said.