Pentagon may drop mental health question

By PAULINE JELINEK and ROBERT BURNS, Associated Press Writers, AP, June 15, 2007

WASHINGTON - U.S. troops would no longer be asked to reveal previous mental health treatment when applying for security clearances under a proposal being considered by the Pentagon.

The idea stems from the finding that service members avoid needed counseling because they believe that getting it — and acknowledging it — could cost them their clearance as well as do other harm to their careers, The Associated Press has learned.

"This is just one of several items under review by the Department of Defense and the services in an effort to remove the stigma associated with mental health issues," said Air Force Maj. Patrick Ryder.

The proposal is to omit a question regarding mental health treatment that appears on a form required by the Office of Personnel Management, the agency that does the majority of investigations for granting clearances to military and civilian workers in the federal government.

Currently, the questionnaire asks applicants whether they have consulted a mental health professional in the last seven years. If so, they are asked to list the names, addresses and dates they saw the doctor or therapist.

The Pentagon has been working for some time to end the stigma of counseling. Studies indicate that soldiers most in need of post-combat health care are the least likely to get it because they fear that others will have less confidence in them, that it will threaten career advancement and that it could result in loss of their security clearance and possibly removal from their unit.

Statistics indicate that the perception of stigma is "far worse than the reality" when it comes to getting security clearances, Ryder said. Last year, less than .05 percent of some 800,000 people investigated for clearances were rejected on the sole issue of their mental health profile, he said.

That's because the clearance process is done on the "whole-person concept" — that is, it weighs a number of factors about the person's past and present, favorable and unfavorable. People can be prevented from getting a clearance if they have been convicted and imprisoned, are addicted to any controlled substance, have been discharged dishonorably from the service or are currently mentally incompetent.

If the application for clearances is changed to omit the question on previous counseling, it would be just a small part of the effort to encourage service members to get mental health care.

An education program for personnel at all levels of the military is among main recommendations of a yearlong mental health study. The task force study, ordered by Congress, called for urgent action to improve care for members of the military, under strain from simultaneous wars in Iraq and Afghanistan, officials said earlier Friday.

A change already made is a program called Respect.mil, Maj. Gen. Gale Pollock, the acting surgeon general of the Army, said at a news conference on the task force report. Under the program, instead of requiring soldiers or their family members to go to a designated location where it's clear they're getting behavioral health care, they can get the care at a primary care center.

The overall conclusion of the report was that it will take more money and staff to keep up with health care needed because of the high tempo of operations in Iraq and Afghanistan. Long and repeated deployments in the wars have been blamed for some of the mental health problems.

The two "signature injuries" from the conflicts — mostly Iraq — are post-traumatic stress disorder and traumatic brain injury, the task force said, adding that the new demands "have exposed shortfalls" on a system that has not been war-focused for decades.

The military also needs to train leaders to understand that physical health and psychological health are equally important, said Vice Adm. Donald Arthur, co-chair of the task force.

"We concentrate a great deal on ... how fast can you run a mile, how many sit-ups and push-ups can you do," Arthur told reporters. "But we don't often concentrate on the psychological health of the service member."

"If you break your leg, it's not your fault; if you get cancer, it's not your fault; if you have a post-traumatic stress reaction, it's not your fault," he said.

Noting that the problem of stigma is pervasive not only in the military, but in American society as a whole, they said the evidence in the military is overwhelming. Fifty-nine percent of soldiers and 48 percent of Marines said thought they would be treated differently by leadership if they sought counseling, according to a survey among troops who had been deployed.

Of even greater concern, the report said, are recent findings that service members who screened positive for symptoms consistent with mental illness were twice as likely as those without symptoms to express concerns about stigma.

"Individuals exhibiting the greatest need were the most hesitant to seek care, even though empirical data from at least one military study indicates that service members do not suffer any negative career impact from seeking services related to their psychological health," the report said.

"Post-traumatic stress, combat stress is an absolutely normal reaction to a very abnormal situation," Arthur said, adding that care can prevent it from turning into a disorder.

"Combat is like nothing else that one can experience in peacetime. It is not like you see in the movies," he said. "It's not 90 minutes of show with 30 minutes of commercials and the good guy wins in the end. You have a real chance of being seriously injured or killed in your service to your nation."