In October 2014, less than six months after graduating high school, my 18-year-old brother took his oath of enlistment into the United States Navy as an Aviation Air Rescue Swimmer. He knew it would be difficult to complete the training program given the rigorous requirements set by the Special Operations department. My brother did not end up meeting the standards, and as a result, was given janitorial duties and other less than fulfilling jobs to complete daily. He was frustrated, disappointed, and overall dissatisfied with his position. He really needed someone to talk to and help him work through this period, but there was no one on the ship, besides a chaplain that he could speak to. The lack of mental health help that was available to my brother led to him sending my parents, my sisters, and I frightening messages. With us living in New Jersey and my brother being stationed in Japan, there was little we could do from the other side of the world to help him.

Many people face mental health illnesses and steps are being taken to help alleviate the consequences of them. Suicide prevention hotlines, free counseling services on college campuses, assuring the public that mental illnesses do not make one weak, and other initiatives of the like were launched to help reduce the stigma surrounding mental health issues and to encourage people to seek help if they need it. Active duty military members do not have the opportunity to take advantage of such programs due to being stationed remotely and the nature of the environment that they are in. Being in the military is extremely challenging and mentally draining – the jobs are stressful, there are traumatic events, and deployed servicemen are away from their families. A report published by the Department of Defense (DoD) noted that it is working on hiring more mental health care professionals to care for the military (U.S. DoD). However, increasing the amount of mental health professionals will not be beneficial unless the Army removes the policy that encourages the health care professionals to avoid diagnosing soldiers with mental illnesses in order to keep them in the line of duty (Thompson 2012) and the stigma surrounding mental health treatment in the military is dissolved (Miggantz). 

Despite the DoD’s efforts, the lack of development of the mental health care system for military members is resulting in lives lost that could have been saved. The rate of military members committing suicide is much higher than the civilian suicide rate and it has increased drastically since the beginning of the millennium (Wells, et. al). As society continues to evolve, it is important that the government continues to reevaluate the programs set in place to increase mental health treatment in the military, so that the effectiveness of such programs can be measured (Thompson 2014). A lack of mental health care while in the service can affect the military members for the rest of their lives in forms of Post-Traumatic Stress Syndrome (PTSD) and Traumatic Brain Injuries (TBIs) (Lentz). Using technology that most people are familiar with, like smart phones and tablets, to serve active duty members’ mental health while they are stationed is an important prospect to consider (Shore, et. al) so that less veterans and their families are impacted long term. Of course, systems can never be perfect and there will always be room for improvement, but it is vital that steps are taken to fully evaluate the military’s mental health care so that active duty members can be better served and brought out of their difficult times alive.

Being a part of the military presents unique opportunities not afforded to civilians, but the opportunities do not come free. Active duty members often face mental health illnesses such as depression and PTSD. The proportion of military members affected by mental health illnesses has been on the rise since 2001. Research found that there is “a positive association between exposure to combat and PTSD” (Wells, et. al).  The government recognizes that more needs to be done to better serve those who are willing to put their lives on the line for the protection of all United States citizens. The different military branches are working on further developing their mental health services and increasing the amount of mental health care professionals that are available to the service members. By using compensation incentives and direct-hire authority, the DoD is making working in the military more appealing for mental health care professionals. It is even incorporating mental health into the primary care setting to make receiving care more streamlined. The sheer number of mental health care professionals employed by the DoD is one main barrier to military members seeking help, but the stigma surrounding mental health illnesses is another large one. Military members are recognized for being courageous and incredibly strong, but the idea that mental illness makes one weak exists not only in general society but also in the armed forces (Miggantz). Service members are often concerned that seeking mental health help will result in negative impacts on careers. Thus, military members who recognize that they are having a difficult time may still not get the help that they need because they are too worried about the reactions from others. 

By not having an adequate number of mental health care professionals employed to care for the military members, the level of difficulty of receiving help is much greater. In recent years, the DoD and Veterans’ Affairs have worked on hiring more health care professionals. However, despite this employment increase, there are still gaps between what is currently available and what is needed.

In the Army for example, there are presently “270 hiring actions open to fill vacant…positions” (Mental Health Counselors). It is important that these vacancies are filled because currently in Iraq and Afghanistan, “hostile forces employ more improvised explosive devices against US forces than previously experienced” (Wells, et. al). The Navy needs to increase the number of clinical psychologists and social workers it has because the manning percentages for each are 88 and 58, respectively (Mental Health Counselors). While the Navy has enough mental health nurse practitioners and psychiatrists, they cannot be used to fill the holes of missing clinical psychologists and social workers. It is vital that the number of psychiatrists in the Air Force increases because “there is risk to shortfall the increase in authorizations for psychiatry” (Mental Health Counselors) unless more are hired.

These spaces need to be filled throughout the various branches of the military. There rates at which military members suffer from mental health issues is much higher than the rate at which civilians do (Willingham). The shortage of mental health care in the military leads to negative implications, such as increased suicide, PTSD, depression, and traumatic brain injury (TBI) rates, on active duty service members. 

It is not uncommon for military veterans to face relationship issues when they return home following deployment. For instance, Todd Kruder is a United States military veteran who suffered from mental health problems following his time in the military. His mental state negatively impacted him and his family. Kruder tried several times to commit suicide but never was he successful. His mental illness led to a change in his personality and as a result, a strain on his marriage. His wife who he had been married to for over thirty years did not know who he was anymore. The two were on the brink of divorce. Mrs. Kruder could not handle Todd’s outbursts. Todd, realizing that he could not lose his wife, sought help. After getting the care he needed from a psychiatrist and other mental health professionals, the Kruders’ relationship began to repair itself. Todd’s mental health illness did not just affect him, it affected his wife, his sons, and his relationships with them (CNS Maryland).

Not only will a lack of mental health care affect military members after they return home, it will also affect them during their time in active duty. In fact, five years ago “mental disorders accounted for more hospitalizations of service members than any other illness” (Lentz 3). Perhaps having more mental health care providers available will keep the rate at which military members are hospitalized for mental health problems lower because the problems will be able to be managed as they develop and not once they become a huge danger. Additionally, by 2011 the reported cases of PTSD increased 650% since 2001 (Lentz 5). This statistic is alarming and could be much lower had there been more care for individuals while in the military. PTSD is not a short-term illness; it affects people’s lives for many years and it can have a huge impact on families. Starting in 2010, suicide is responsible for the second highest number of military deaths (Lentz 10). People use suicide as a way to escape from problems that they feel are irresolvable. A higher number of mental health care providers can help decrease the presence of suicide in the military by giving the service members an outlet, a place for them to talk and work through their struggles. So much can be done to help the mental health aspect of a military member’s life, and it is important that there is increased accessed to mental health care because people’s lives are on the line.

By hiring more mental health care professionals, there will be more available to the military members. As a result, this can make room in clinic schedules for mandatory mental health check-ups before and after deployment. Research shows that “exposure to mental health treatment in the past decreases one’s level of perceived stigma” (Miggantz). Providing mandatory check-ups will give military members who have never had mental health treatment a look in to mental health services, making it a less foreign concept.

It is unfair to say that the government is not working on improving the military’s military health care. In recent years, the DoD has employed more mental health care professionals to serve the military (Mental Health Counselors). Additionally, the government is working on new platforms that military members can receive mental health care. The idea of providing mental health care through smartphones and tablets is being explored. These materials can offer services such as questionnaires and cognitive behavioral therapy (Shore, et. al). This will make receiving the necessary care even easier because the technology can be taken anywhere. It will make it easier for the military members to get care because it will be at their fingertips. By being able to text mental health care professionals, the active duty members can get questions that do not require an appointment answered without cluttering clinic appointment schedules (Shore, et. al). 

Despite the government’s efforts to better serve the military members in terms of mental health care, there is not any definitive proof that the newly developed programs are truly helping. A former Army colonel, Elspeth Ritchie, is not surprised by this information given the attitude the government had towards new programs. According to Ritchie, the government came up with a large amount of ideas and just used everything that they came up with to see what worked, instead of researching what the best options would be (Thompson 2014). The new programs are “evaluated infrequently or inadequately” (Thompson 2014). For example, one particular study had a sample size that was too small to produce a significant result. It is important that the government finds accurate ways to measure whether its programs are successful or not. Without having a clear understanding of whether the programs stand in terms of effectiveness, the necessary changes are unknown and therefore cannot be made. By not properly assessing the new services the new services can be a waste of resources because they may not be helping the situation and can be taking away from what is truly needed to better provide mental health care to military members.

Healthcare of any sort is complicated and it becomes more complex when dealing with military members due to them having chaotic and obscure schedules. However, mental health illnesses are extremely destructive and not only impact the person directly affected, but also those around them. It is vital that access to mental health care is increased for active duty service members so that they do not have to go through the same situation as my brother. Fortunately, my brother worked through his issues, but it could have been easier if there were mental health professionals available to him. No family should have to worry whether their military member is getting the care that he needs.
