Commentary Search

P.T.S.D. - Why people avoid mental health treatment

BARKSDALE AIR FORCE BASE, La. --

[Editor's Note: After coming home from Afghanistan in 2011 two members of my Provincial Reconstruction Team committed suicide. While I don't know what struggles they faced, I know this problem is real and we are not doing enough to build a community resilient to these mental health challenges. I don't mean the official military programs and trainings. Instead, we need to engage as brothers and sisters at arms to help our fellow servicemembers.

We train for every aspect of war. We exercise our bodies to be ready for the grueling physical stress we'll face. We learn about our weapons and our enemies to be able to outsmart them. What we don't do is take a proactive approach to training our minds to be strong in the face of trauma and stress. We get treatment for a twisted ankle or a gunshot wound. Why would we not do the same for our mental health?

War is not isolated to distant battlefields. We bring it home with us. We must fight that war as strongly at home as we do overseas. - Capt. Andrew Caulk, Chief, 2nd Bomb Wing Public Affairs]

The stigma of seeking help for mental health conditions exists in our general population and within the military community. Stigma can cause a person to deny symptoms, delay seeking care or stop them altogether from beginning treatment. During the month of June (Post Traumatic Stress Disorder (PTSD) Awareness Month) we are encouraging you to be part of the solution. Having a greater understanding and awareness of PTSD can help service members and others recognize symptoms, and seek help and save lives.

Perceived Stigma: If you had a cold, sore throat or an infected cut, you might consider taking some medication to alleviate the symptoms. Most people would not interpret your actions as a weakness. Sadly, there is a stigma that suggests if you are weak if you need mental health help.

A 2007 survey of the U.S. population noted the most adults with mental health symptoms (78%) and without mental health symptoms (89%) agreed that treatment can help persons with mental illness lead normal lives. It discovered that 57% of all adults believed that people are caring and sympathetic to persons with mental illness, yet only 25% of adults with mental health symptoms believed that people are caring and sympathetic to persons with mental illness. For those with PTSD symptoms, the internal belief that others will judge them for seeking help can be a barrier to receiving proper care.

Time: Some people delay seeking medical care, thinking their problems will improve over time. Unfortunately, symptoms do not always resolve on their own. A barrier for some is the time it takes to attend medical appointments. Concerns may exist that that time away from work will delay completion of job duties or the time away is looked at with a negative perception from their peers. Most medical providers agree that the earlier you seek care for a medical condition the more likely the condition can be resolved or mitigated. What may surprise you is that many temporary mental health conditions can be treated within four to twelve sessions. For instance, one Evidence-Based Treatment (EBT) for PTSD, Cognitive Processing Therapy (CPT), is a 12 session focused intervention that has shown to effectively reduce problematic symptoms. CPT, and many other EBTs are available on an outpatient basis at any military mental health clinic.

The healthier your team is the more efficient and productive they are. Imagine someone coming to work with a headache every day and how that might impact their performance. Social, emotional and psychological stressors can be like a headache that distracts, with the potential to lead to job errors or mission failure. Be aware that some medical conditions may require frequent follow-ups, like physical therapy and mental health appointments. The medical staff works to provide timely treatment with the ultimate goal and intent to return patients to work centers without restrictions. The investment in treatment can have huge payoffs in productivity and quality of life enhancements.

Security Clearance: Visiting mental health does not immediately revoke someone's security clearance. DoD 5200.2-R, Personnel Security Program, advises commanders to use a common sense approach. For mental health or substance use, the guidance clearly illustrates that treatment and symptom improvement can mitigate security concerns. Most mental health conditions respond well to treatment and the unit is never notified.

Also, when completing a security clearance renewal (Form SF86), be sure to answer the questions honestly if you have a history of mental health care. The form clearly reads that “mental health counseling in and of itself is not a reason to revoke or deny eligibility for access to classified information or for a sensitive position, suitability or fitness to obtain or retain Federal employment….” Additionally, the instructions state to answer “No” to history, if counseling was not court ordered and was strictly for marital, family, grief not related to violence by you; or strictly related to adjustments (e.g., PTSD) from service in a military combat environment; or strictly related to being victim of a sexual assault. Bottom line: seeking mental health treatment (e.g., counseling or medication management) will not lead to automatic suspension or loss of a security clearance.

Duty: Another reason people avoid mental health treatment is concern that it will impact their career progression. Fortunately, this is not the case. However, an untreated condition may impact an Airman’s ability to perform primary duties and raise questions of his or her continued fitness. Having superior mental health is what leads to career success.

For some in treatment, a mental health provider will initiate a profile with recommendations to limit travel or moving to a new base to ensure you can follow-up with care without interruptions. Most commonly, temporary profiles are entered for patients who start a new psychotropic medication. Medical profiles are shared with commanders, however, the commander does not receive the diagnosis. Many AFSCs are able to continue with their primary job roles while on a profile; however, for those on flying status or within the personnel reliability assurance program (PRAP) the profile may include recommendations for temporarily not flying or PRAP suspension due to specific job regulations. The vast majority patients regardless of status in special programs return to duty without restrictions.

PTSD symptoms such as intrusive and unwanted memories of the traumatic event, avoidance of reminders of the event, negative thoughts/mood, high physical tension/arousal don’t have to interfere with everyday activities, work or relationships. Treatment can help you get better.

Untreated, severe PTSD can degrade your quality of life and relationships. There are countless success stories of those who have used mental health services to enhance their resilience.

Be there for your family, friends, peers and coworkers and be part of the solution to encourage seeking help when needed. You can help them heal by connecting them with a Chaplain, a Military and Family Life Counselor, their doctor, the Behavioral Health Optimization Program, or mental health counselor. There is also the Veterans Crisis Hotline (800-273-8255 press 1) as a resource that is available 24/7 and is confidential.

Be the solution to change the culture and help reduce barriers for those seeking or receiving treatment for mental health issues.