Behavioral health care was more readily available to deployed soldiers in 2005 than in previous years, and the stigma with seeking this kind of care is decreasing, according to an Army report released today.
The Department of the Army announced today the results of the third Mental Health Advisory Team, which traveled to Iraq during October and November 2005 to assess the behavioral health requirements of soldiers in theater, and how well medical services are meeting those requirements.
“This study confirmed that the improved (Operation Iraqi Freedom) behavioral health care system is helping soldiers deal with the stress of combat,” Army Lt. Gen. Kevin Kiley, Army surgeon general, said during a media roundtable today.
“Behavioral health care providers reported confidence in their ability to treat combat and operational stress reactions,” he said “Soldiers reported higher unit morale than in previous studies and generally reported high job satisfaction.”
The report’s key findings included:
Soldiers were more likely than those in previous studies to report more intense and predictable combat experiences as a result of the use of improvised explosive devices.
The top non-combat stressors were deployment length and family separation.
Participants reported their units' morale was higher than in previous studies, while their personal morale was higher than reported on MHAT I and similar to that of MHAT II.
Fourteen percent of the soldiers surveyed indicated they experienced acute stress and 17 percent indicated a combination of depression, anxiety and acute stress. These were similar to the rates found in 2003 and higher than in 2004.
Soldiers serving a repeat deployment reported higher acute stress than those on their first deployment.
The suicide rate among soldiers in support of Operation Iraqi Freedom (Iraq and Kuwait) during 2005 was 19.9 cases per 100,000 soldiers—similar to the 18.8 rate per 100,000 soldiers in 2003 and higher than 2004.
Soldiers reported receiving suicide prevention training before and during deployments, but the number who perceived this as useful in identifying fellow soldiers at risk declined from 60 percent in 2004 to 55 percent in 2005. The study determined that leading suicide risk factors were relationship issues at home and in theater, followed by legal actions, problems with fellow soldiers and command and duty performance.
Behavioral health providers were confident in their ability to treat combat and operational stress reactions among soldiers.
Soldiers generally reported high job satisfaction and good support facilities. They were unhappy with tour lengths and reported a more dangerous combat environment than during OIF I. Multiple deployers said they were better prepared due to improved pre-deployment training, but also said their families are experiencing more stress and the time between deployments is too short.
In the study, known as MHAT III, 95 percent of the soldiers surveyed reported readily available mental health care. In MHAT I, conducted in 2003, the rate was 85 percent, and in MHAT II, in 2004, 93 percent.
To measure the stigma associated with seeking behavioral health care, soldiers were asked five different questions, said Army Col. Edward Crandell, the leader of MHAT III.
The number of soldiers who agreed there was stigma associated with seeking this care decreased significantly from MHAT I to MHAT III, Crandell said.
“If stigma is decreasing, and access is increasing, then availability of treatment and soldiers’ willingness to go increases,” Crandell said.
The MHAT was composed of 12 people, including subject matter experts in psychiatry, research psychology, clinical psychology, psychiatric nursing, occupational therapy, chaplain, social work and enlisted mental health specialties.
MHAT III conducted surveys and focus-group interviews with soldiers and with health care providers. Altogether, 1,461 soldiers, 172 behavioral health providers, 172 primary care providers and 94 unit ministry team members participated.
MHAT III for the first time included soldiers from Multinational Security Transition Command Iraq, who advise and train Iraqi security forces. It also included soldiers who were on their second deployment to Iraq.
Since MHAT III concluded in 2005, the Army has already made improvements in the behavioral health care system, Kiley said. The Army is establishing a suicide prevention cell to further analyze data on suicides and suicide attempts to provide lessons learned to leadership and the behavioral health community. The Army has also developed pre- and post-deployment training for soldiers and their families, known as “battle mind training,” he said.
“We must support our soldiers’ health needs, both physical and mental; these advisory teams help us to know how and where we can better meet these needs,” he said. “We will continue to review the recommendations from the team and further improve behavioral healthcare for soldiers deployed to Iraq and Army-wide. Our goal is to ensure that every deployed and returning soldier receives the health care that they need.”
Kiley noted that in his 30-year career, he has never seen a commitment as strong as the one demonstrated by Army leadership in developing these mental health advisory teams. Behavioral health care is an important issue that requires constant improvement, he said.
“Our efforts in education, prevention and early treatment are unprecedented,” Kiley said. “Our soldiers are a testament to these efforts. The majority of soldiers, because of superb training, will adapt to the stressors of war.”
Story by Sgt. Sara Wood, USA, American Forces Press Service