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Military faces big hurdles in goals for mental health care
USA TODAY - September 27, 2007
The Pentagon said it would take at least eight months to complete major improvements to its mental health program, which treats troops with post-traumatic stress disorder and other conditions.

The military made the announcement this week in response to a task force report issued in June that found mental health care for the troops and their families "woefully inadequate."

The Pentagon said that key issues, such as hiring more mental health caregivers and increasing coverage under the military's health care system, could not be met until May of next year or later.

The Army announced in June it would hire 200 civilian psychiatrists, psychologists, psychiatric nurses and social workers. It later raised that to 265, a 23% increase in those job categories for the Army. By last week, the Army had filled 40% of the jobs.

Sen. Joe Lieberman, I-Conn., who pushed for the task force, applauded the Pentagon's plan but called for quicker action.

The shortage in Army uniformed therapists is having an impact on the war in Iraq, where Navy and Air Force counselors are helping the Army treat soldiers. The number of mental health providers has not kept pace with the additional 30,000 U.S. troops sent to Iraq this year, according to Army statistics provided to USA TODAY. In addition, the Army says some mental health counselors are burned out by their war experience.

"Medical providers are fatigued by the strains of the caring for injured soldiers and soldiers suffering from the psychological effects of deployment, including PTSD," says Col. Elspeth Ritchie, psychiatric consultant to the Army surgeon general, referring to post-traumatic stress disorder. "We are planning to put additional providers at each major installation specifically to support providers."

Experienced therapists continue to leave the military for better-paying and less stressful jobs in the private sector. The Navy, for example, expects to lose a dozen of its 88 psychiatrists this fiscal year and 25 of 116 psychologists, according to data released at a Marine Corps conference in June. Incentives have been created to keep or recruit new psychiatrists and psychologists, including retention bonuses and college loan repayment offers.

In its response this week to the June task force report, the Pentagon listed several goals it could not meet until May. They include additional staffing and ensuring that military spouses and children have better access to mental health care.

Another two dozen recommendations will not be met until beyond May, the response says. Those include a recommendation that any access to mental health care for military families be "timely."

The Army is preparing a recruiting program aimed at older physicians and mental health providers, age 48 to 60. They would allow for enlistments of only two years, Army Col. Larry Bolton says.

Meanwhile, the level of mental health care in the Iraq war zone -- as a ratio of providers to troops -- is the lowest since 2004, Army statistics show. Care has dropped from one counselor per 668 troops last year to one for every 743 this year.

Ritchie and Army Col. Carl Castro, a psychologist who has studied war zone care, say they believe the ratio is still adequate.
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