"The military is reliant on self, focused on the other, mission first, stop whining, suck it up," Van Dahlen said. ''It's only in the last 10 years that the military, to its credit, started to think about, OK, we had better focus on taking care of our mental-health needs or we are going to be in trouble."
Growing alarm about suicides and violence within the military has prompted unprecedented efforts to beef up systems to help soldiers cope with multiple deployments and adjust to life after war. The Army has launched the largest-ever study of mental-health risk and resilience among military personnel, and set up a $US65 million facility dedicated to treating traumatic brain injury, post-traumatic stress disorder and other psychological problems.
The military also has started deploying psychiatrists and counsellors to serve alongside soldiers in war zones and conducts therapy sessions for returned soldiers and their families.
Despite these efforts, there have been hundreds of active-duty suicides since 2011, according to figures from the Army and non-profit groups. Some advocates believe the military lacks adequate funding to identify and treat mental issues and that many of the diagnostic tools available are outdated and inadequate.
For example, post-traumatic stress disorder is diagnosed using a list of questions.
"Imagine going to your doctor because you think you have a broken leg and your doctor asks 20 questions," said retired General Peter Chiarelli, a former Army vice chief of staff. "And then your doctor says, 'You don't have a broken leg. You can go home.' You'd say, 'Aren't you going to X-ray my leg?' That's how we diagnose PTS."
The military, he said, needed to fund research aimed at developing more advanced tools, including brain-imaging scans and blood tests. General Chiarelli also said the military's efforts to hire more clinicians to diagnose and treat post-traumatic stress had been impeded by an overall national shortage. That, in turn, has led to an over-reliance on prescription drugs instead of more time-consuming treatments.
Nonetheless, some Army officials say, the resources provided at installations such as Fort Hood are quite substantial. But the demand for them is high. Fort Hood, and the Darnall Army Medical Centre there, provides psychiatrists, psychologists and family-life chaplains to help people with anxiety, depression and post-traumatic stress.
"Could we use more? There's always a need for more, especially after 12 years at war," said a mental health professional at Fort Hood.
Washington Post
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