Mental health teams deploying to frontlines with Marines in Iraq

mental health teams deploy with Marines

8:30 a.m. February 10, 2008

CAMP PENDLETON – Navy Chaplain Dick Pusateri has witnessed the stress of war on the faces of troops put in harm's way daily, in the strained relationships of families facing long deployments and the confessions of men shaken by the human cost of war.
For too long, chaplains were among the few people combat Marines felt they could turn to in a crisis.



AdvertisementThe Navy and Marine Corps aim to change that by sending teams of mental health professionals to the frontlines this month, after studies showed a jump in the past five years in cases of combat-related mental health disorders, primarily post-traumatic stress disorder.
“We've got a lot of knowledge about the way combat trauma affects people, and having somebody there to guide Marines through it in Iraq means we can respond to it more quickly,” Pusateri said.

While psychologists and psychiatrists have long treated military service members on bases and in field hospitals, the deployment of teams of psychological professionals – one per regiment – next month to combat zones marks a new approach in identifying and treating mental health before problems arise.

The teams assigned to the 1st Marine Expeditionary Force – made up of about 11,000 Marines – will include a psychiatric technician, a chaplain and, in some cases, a Naval social worker. Psychiatrists or psychologists could deploy to forward operating bases and, in extreme cases, patrol with units.

Three top commanders of the U.S. Marine Corps' fighting forces recently asked to make the pilot program a permanent fixture.

“Now is the time to adjust fire,” the generals wrote in a letter to the commandant. “We must shift the current direction of combat/operational stress control efforts to a more holistic, nested enabling strategy that provides a sound, unified approach.”

Marine commandant Gen. James T. Conway is reviewing the request and a decision is expected later this year.

The Army adopted a similar approach last year, and has been deploying behavioral health specialists to patrol with its troops in Iraq and Afghanistan.

“What is probably new here is that we want to address it close on the frontlines, and thereby return people both back to combat and back to society healthy,” said Navy Capt. Mike Maddox, the 1st Marine Expeditionary Force surgeon.

The push to make the program permanent comes after a report by the Institute of Medicine found post traumatic stress disorder is the most commonly diagnosed mental disorder among veterans. It affected an estimated 13 percent of those returning from Iraq and 6 percent from Afghanistan.

Figures released by the Marine Corps show a fourfold increase in the number of Marines diagnosed with PTSD – from 394 in 2003 to 1,669 to 2006.

“If we identify a stress and if we can treat it close to the unit, it's less likely that person will be sent back, medivaced out of there,” said Cmdr. David Oliver, the 1st Marine Expeditionary Force psychiatrist.

Previously, Marines identified with possible combat-related mental health stress or disorders have been pulled from duty in Iraq and shipped to the U.S. or Germany for assessment and treatment.

Under the expanded program, mental health specialists would be in daily contact with troops at forward bases, working with chaplains to identify potential risks to troops, talking with squad leaders about their troops, and responding to IED explosions and other combat situations that could effect a Marine's mental health.

While certain combat-related mental health conditions may require extended care, most of the cases in Iraq can be treated or eased.

In some cases Marines or sailors showing signs of stress, such as sleeplessness, anxiety or agitation, may just need a rest.

“In many cases, he's probably not going to have problems if he's given the chance to get some sleep, get some hot chow, take a hot shower,” Oliver said.

In more serious cases, identifying the problem early gets the person needed treatment more quickly and gives them a better chance for recovery.

The success will largely depend on the ability to convince Marines and sailors to seek help.

“There's a stigma. Take that stigma away, the more and more you will be able to break down that barrier for Marines,” said Lt. Col. William Swan, who attended a conference this week of military officers and mental health professionals meeting to make permanent the pilot program.

While the Marines have adopted stiffer deployment and post-deployment mental health screening measures, critics say the problem remains that Marines are stigmatized if they seek help.

That claim was bolstered last year by the Washington-based advocacy group Veterans of America, which found Marines were reluctant to seek help for post traumatic stress disorder and other problems.

If left improperly treated, problems can worsen. On the frontlines, that can have disastrous consequences, as it appeared to have in March 2006 when an Army private who sought military medical help for stress later allegedly killed an Iraqi family.

Maddox said the stigma of seeking help is dissipating among younger Marines because mental health assessment has always been part of their training.

Lifelong Marines, though, have shown the most resistance to the program. He said awareness and education were the key to overcoming resistance.

For many troops, it will be the first time they come face-to-face with psychologists near the frontlines.

Cpl. Ben Eberle, 25, of Fairview Heights, Ill., said he liked the idea of having someone nearby to talk to, if needed. Seeing the team members around the base would make it easier if he or one of the men in his unit need to talk to someone.

“If I know that person, and I am on a conversational basis and I've met that person in the past, I would be totally comfortable talking to that person,” he said.

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