On Combat

Psychological needs of military personnel and their families are increasing—straining military health care system, reports an APA task force. Serious barriers to mental health care exist due to shortage of providers, reduced access to care and stigma of seeking service.

This week, these headlines trumpeted an American Psychological Association preliminary report on US military psychological needs. The effort was part of a Presidential task force on Military deployment services for youth, families and service members.

The APA found that availability, accessibility, and acceptability are major obstacles to the psychological health of US warriors and their families. Specifically:

· Adequate psychological health care is not available, primarily due to availability of trained health car professionals

· When it is available, it is not easily accessed due to scheduling and other concerns

· US military culture shuns mental health treatment and individuals may be deterred from seeking help by anticipated negative impacts within their

Although many of the APA’s findings will be no surprise to many, the factual evidence behind their findings are extremely helpful in making the case for improvements. Other strong points of the study include a narrative on typical military member and family problem areas during each unique step of the pre-deployment, deployment, reunion, and post deployment cycle.

Another strength is the depth of the bibliography of current literature on the topics of PTSD, family stress, and current operations.

Although part of the report seeks to describe the 21^st century military, the authors seems to have completely missed the point that today’s military is a professional volunteer force, contrasted to the draftee military in Vietnam. America’s conscript Army in Vietnam faced a vastly different problem because the typical draftee was inducted, trained, did a year in Vietnam, and then was out of the military a few months after returning from the war. Warriors in today’s professional force face multiple deployments over longer enlistments. Longer enlistments also mean service members are more likely to marry and have families than the generation of soldiers that fought Vietnam. This is a minor criticism, however, because the effect of multiple deployments on the warrior and family is well-described in this study.