Dogging It On 9/11

As a blog that I wrote here last year ("A Memorial Day for Mental Illness in the Military", May 26, 2011) indicated, I've long been dismayed at the lack of preparedness and resources devoted to behavioral healthcare in the military in the 11 years since 9/11/01. 

More recent information indicates that not much has gotten better in the last year and a half:

-July, 2012 was the worst month for Army suicides since data began to be collected and released in 2009; -the Purple Heart still can not be awarded to troops suffering from combat-related PTSD (or any mental disorder, for that matter); -mental disorders now account for more hospitalizations, about one in five, among active duty service members than any other major illness or injury; -female soldiers are more at risk for rape and harassment than enemy fire, and have an overall incidence of PTSD to rival men; -military spouses and children at home end up having as much diagnosable anxiety, depressive, and other disorders as do the service members themselves; -given the inadequate staff for the mental healthcare needs and the likelihood of secondary trauma from working with the traumatized, the caregivers must also be increasingly vulnerable.

Sure, we may now have parity in mental healthcare outside of the military, but apparently not in it.

But hope springs eternal. A new Presidential election is on the horizon, so I was curious to see if the candidates would say anything about this topic in their well-watched acceptance speeches of their nominations. Well, not only did Mitt Romney not mention military mental health, but he was the first Republican nominee sine 1952 to not mention war at all in such a speech.

OK, I thought afterwards. Since his party started the war on terrorism in Iraq under false pretenses in the first place, maybe he wanted bygones to be bygones. Perhaps President Obama would do more. 

And he did. Up to a point. He talked of ending the war in Iraq; planning to end the war in Afghanistan in 2014; and of course, that Osama Bin Laden is dead. Great, but I (and I assume most of the

viewers) knew all that already. So my ears perked up when he then said:

"Tonight we pay tribute to the Americans who still serve in harm's way . . . When you take off the uniform, we will serve you as well as you've served - because no one who fights for their country should have to fight for a job, a roof over their head, or the care they need when they come home". (Much cheers, applause).

OK. Better. I could just about mouth what I hoped would come next from President Obama.

(And the care they need right there and when they come home is much further expansion and development of mental healthcare for PTSD, right now and for many years hence. The incidence for PTSD is at least 20% and will rise over time).

If he said for many years hence, I would know that he now knew that PTSD could emerge many years after the trauma, maybe even longer than has been thought if the effects of emotional trauma can be epigenitically passed through sperm, and that he cared enough to put into place what would be still needed after his Presidency ended. But nothing. My reverie ended as he was on to the next subject.

Again, I remained hopeful. Maybe the details of such a "care" plan would be conveyed soon after the speech. Instead, the next morning, in the daily American Psychiatric Association on-line Headlines, this item jumped out at me:

"VA Decides Not to Cover Costs of Service Dogs For PTSD Treatment"

The blurb went on to say that such service dogs will continue to be covered for those with impaired vision, hearing, or mobility, but not for mental disabilities. Actually I found out that this news came out the day before his acceptance speech in the Federal Register:

" . . . said that despite many individual Veterans' testimonials that mental health service dogs provide relief from the symptoms of combat- related disabilities, such as post-traumatic stress disorder (PTSD), it lacked research substantiating the efficacy of mental health service dogs".

What a rationalization! Or excuse. Aren't there so many treatments for various medical and psychiatric disorders still covered by the military that never received research substantiation? More than that, weren't expertly trained dogs tried because more standard and traditional treatments for PTSD in the military were failing too often, and therefore not efficacious? And did the military not take into account the burgeoning role of therapeutic dogs in other aspects of mental healthcare, including children with severe behavioral problems?

The Armed Forces claims that stigma about receiving mental healthcare is a large part of the problem in not asking for help or in denying that one has severe mental distress. But doesn't eliminating the less- stigmatizing dogs, "man's best friend", and keeping the Purple Heart only for visible wounds, just increase that stigma?

In sports, "dogging it" refers to not putting in enough effort to succeed. That seems to be the case for the policies pertaining to military mental healthcare. It may also apply to us outside of the military if we remain silent and passive about this problem. Remember that those in the military who understand the nature of the inadequate mental healthcare will have much less opportunity to speak out critically without jeopardizing their own well-being. We are our brothers' keepers. Is there something collectively that we can say or do?