Reagan takes a proactive approach to mental health

U.S. 7TH FLEET AREA OF RESPONSIBILITY

06.10.2020

Story by Canadian Forces PO 2 Cameron Edy    

USS RONALD REAGAN (CVN 76)   

Reagan takes a proactive approach to mental health

By Mass Communication Specialist 2nd Class Cameron C. Edy

In anticipation of deploying amid a global pandemic, the Navy’s only forward-deployed aircraft carrier, USS Ronald Reagan (CVN 76) has taken a proactive approach to its Sailors mental health.
Not only does Reagan have its standing ‘mental health triad’, consisting of Chaplains, a Deployed Resiliency Counselor and a resident psychologist, the carrier has brought aboard a doctoral social worker, and a psychology technician. These specialists allow Reagan to treat Sailors struggling with depression, anxiety and other mental health issues during an evolving deployment.
Healthy anxiety is an important part of a Sailors everyday life. Without healthy anxiety, Sailors would experience a lack of motivation and an inability to achieve their goals. Lt. Croke, Reagan’s psychologist, explains the spectrum of anxiety, and what happens when a Sailor’s anxiety becomes unbalanced.
“Try and think of anxiety on a spectrum,” said Croke. We need a certain degree of pressure to accomplish the mission and feel capable about doing so. But when anxiety starts to go overboard and we become overwhelmed, we can lose that ability to get the job done. We become more concerned with failing, which can eventually result in burnout.”
Anxiety can come and go over time, but when triggered during a normal routine, it can impact a Sailors work in a major way. Croke went on to explain how reactive avoidance can cripple a Sailors life, and their ability to complete the mission.
“One of the negative go-to coping mechanisms for a lot of Sailors is avoidance strategies” said Croke. “A good example is the flight deck. If someone has to work on the flight deck, but every time they get close to it they feel severe anxiety, the easiest way to deal with it is to stay off the flight deck. But they need to be on the flight deck to do their job. My job is to help make them comfortable doing so without it becoming overwhelming.”
Croke has a six-year doctorate in clinical psychology with a focus on anxiety disorders. He is uniquely qualified for evaluating and treating the anxiety that accompany intense mission operations, and he explains how he evaluates and treats Sailors suffering from anxiety.
“Most research has shown the most effective way to address anxiety is through different levels of exposure,” said Croke. “The best example of this is in 2018 after we had the helo crash. I worked with a number of Sailors that had significant anxiety working on the flight deck again. To treat them we started out by going up to the catwalks, and being around the helo’s again. For many, just hearing the helicopter blades and watching them take off would make them want to go back down below-decks. We slowly exposed them to elements of the flight deck, until they were comfortable doing their job again.”
While not necessarily linked, anxiety can often lead to, or be entwined with, depression. Depression often comes in the form of ‘vegetative symptoms’ such as lower energy, difficulty getting out of bed, more fatigue, and a lack of joy from activities that previously relieved stress. Depression also comes with overarching considerations, such as the patient’s likelihood of self-harm or harming others, making treatment vary depending on the severity of the case. Cmdr. Danyell L. Brenner from Joint Base San Antonio, Texas, is a doctoral licensed clinical and board certified social worker augmenting Reagan’s mental health team while underway. She explains the primary concern when treating depression and the steps mental health professionals take to intervene in a depressive spiral.
“Our primary concern is the patient’s safety and secondly, the patient’s ability to complete the mission,” said Brenner. “We look at their thinking patterns and the causes of that depression, and depending on the specific case we’ll approach treatment from different angles. We use both conventional talk-therapy, as well as medication depending on the circumstance. Usually we’re using a variety of different routes to provide that individual the level of treatment they need to be healthy again.”
Treating mental health can be difficult, even without the added rigors of underway operations. Effectively ensuring the mental wellness of Sailors aboard a forward-deployed carrier requires an equal mix of empathy and dexterity. Croke elaborated on how the Reagan mental health team treats cases aboard the ship.
“We go over a lot of their history, looking at factors such as sleep, diet, exercise, alcohol consumption, and what their goals are for treatment. After meeting with Cdr. Brenner or myself, where we’ll go in-depth and discuss the particulars of the treatment. When treating a patient, I primarily practice cognitive behavioral therapy, which is looking at how thoughts, emotions, and actions are intertwined with mental health. We utilize the most up-to-date evidence based treatments and if indicated, medicinal therapy, when it comes to addressing depression.”
When a mental health issue is too severe to be effectively treated onboard, a Reagan mental health provider can recommend a follow-up offsite treatment. Croke explains the steps the Navy takes when dealing with more-intense cases.
“If there are significant concerns with a Sailor’s ability to receive adequate treatment, here or at Yokosuka, we have something called limited duty, similar to what would happen if they received a physical injury we can’t treat oversees,” said Croke. For example, in San Diego they have intensive out-patient programs for mental health, as well as an in-patient psychiatric facility. If someone needs that level of care, they would get up-to six months; meeting in groups and individually to focus on treating their depression, anxiety, Post-Traumatic Stress Disorder (PTSD) and other mental health issues.”
One of the major issues in the field of mental health is the stigma that comes with treatment. While there are many programs and campaigns to break down that stigma, getting people to talk to a mental health provider is still difficult at times. Brenner explains the stigma behind mental health, and how Reagan’s command climate has assisted in changing that mentality.
“Stigma is something that mental health has always had to address,” said Brenner. “The reality when being in the Navy is understanding that one of the most essential elements of a fighting force is our mental wellness and ensuring we are all mentally fit to do this difficult job. Throughout history we’ve made a lot of progress, and much of that progress comes from individuals of all ranks, rates, and backgrounds coming forward and asking for help. The military, and the Navy specifically, has a significant focus on preventing suicide, and leadership is always thinking up ways to protect its Sailors, ensuring they remain safe and have longevity, both in and out of the uniform.”
Croke added that command involvement is an essential part of a command’s mental fitness.
“One of the most powerful things is when an officer or chief advocates to their junior Sailors the benefits of speaking with us, or a Chaplain,” said Croke. “Those kinds of conversations, with a leader you trust, are integral to reducing the stigma.”
A major part of Reagan’s proactive approach to mental health is its Green Ribbon program. Approximately 45 Sailors, supervised by Croke, are trained in Applied Suicide Intervention Skills Training (ASIST) and Safe Talk, a DOD-seasoned class. These Sailors are embedded in each of Reagan’s departments, as a conduit between Sailors on the deck-plates and Reagan’s mental health professionals. Croke explains the importance of the Green Ribbon Program, and how its outreach assists in proactive treatment.
“Green Ribbon representatives are typically Sailors that are already big advocates of mental health, they’re interested in the field and helping their fellow Sailors,” said Croke. “I pass down the appropriate information to these Sailors, so they can answer any questions or concerns regarding mental health resources available on the Reagan. While they’re not your therapist, they’re trained to recognize and assist anyone who needs help but doesn’t know who to reach out to.”
Ensuring mental fitness is the responsibility of each Reagan Sailor. Croke wants all Reagan sailors to understand that seeking help is not a sign of weakness, nor is it a last resort.
“Sailors struggling with depression or anxiety need to understand they’re not alone,” said Croke. “There is help available, and we highly encourage them to come see us. It doesn’t matter if it’s one in the morning or sometime in the afternoon, we are here 24/7 for our Sailors.”
Even thousands of miles from home, Reagan is able to provide the gold-star of mental health services, ensuring the carrier remains capable of executing its mission no matter the circumstance. Brenner emphasized how mental health is a communal effort on-board.
“It really is a one-team one-fight effort,” said Brenner. “It’s not just mental health element; it’s how we lead, how we take care of each other, and how we come together as a fighting force to ensure Reagan can respond to anything that happens. This pandemic is a perfect example of how we’re capable of that. While things can be chaotic and scary in these uncertain times, Reagan has the best of the best, and we’re doing an amazing job of taking care of each other.”
Ronald Reagan, the flagship of Carrier Strike Group 5, provides a combat-ready force that protects and defends the collective maritime interests of its allies and partners in the Indo-Pacific region.
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• Date Taken: 06.10.2020
• Date Posted: 12.30.2020 06:43
• Story ID: 386057
• Location: U.S. 7TH FLEET AREA OF RESPONSIBILITY