For military reservists - we don't need more "research" to discover what services are needed, just ask the end-users themselves...right now

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Guest Morning Zen Blogger - Dr. Col (Ret) George Patrin
The June issue of the American Journal of Public Health includes a paper called Prevalence Of Perceived Stress And Mental Health Indicators Among Reserve-Component And Active-Duty Military Personnel  American Journal of Public Health. 2012 Jun; 102(6): 1213—1220).

This study discussed mental health threats related to deployment and therefore separation of active duty troops from their family members to life-threatening locations. While there are some civilian jobs where certain danger is associated with the profession, and potential for death, none is quite like the military, impacting both active duty and reserve military personnel and their families. "Deployed reservists (would) report higher rates of suicidal ideation and attempts than active-duty personnel or reservists who had not been deployed" because they are not returning to a military post community with services in place to help them adjust. Their home towns are often not close to any direct care military clinic and VAs don't see them unless a 'claim' is complete documenting a 'line-of-duty' injury. And as we know, the obvious physical injuries (amputation) are acted on much more quickly than the hidden wounds (PTSD). The civilian employer for reservists is not user-friendly, and even hostile, making the employee responsible for having left the business, upsetting productivity, even though patriotism, on the surface, is supported. Also, non-military citizens probably don't realize separating the Reservist or AD Servicemember from Active Duty ends support for the family (only when the Reservist is on Active Duty are FMs covered).  New policy needs to be implemented to protect the Reservist and Guardsman.

Frankly, all studies done by the DoD are suspect, such as the "U.S. Department of Defense Surveys of Health-Related Behaviors (HRB)," especially when they are "self-reports." This concern is true even for "self-administered anonymous paper questionnaires." The study can really only state "active-duty personnel were more likely to (be honest about) stress associated with military duties than traditional and full-time reservists." Servicemen don't generally answer them truthfully, as all surveys are considered likely to negatively impact a military career. The stigma against having a mental health diagnosis is prevalent in the military and civilian sectors, as at the first hint of "behavior problems" the Commander's (and other employers) first response is to recommend "administrative discharge," relegating the troop to the VA to sort out whether there is an on-going injury and ability to serve. The conclusion that "(Active Duty) were more likely to need further evaluation for depression than traditional and full-time reservists" is suspect. Reservists simply aren't offered or don't ask for "further evaluation" as it disrupts their civilian duties too much. They need to "get back to work."

Regarding the statement "there was no significant difference between active-duty and reservists in the level of family stress," I again question the validity of analysis, except to say both segments would be stressed, but FMs have less to lose by admitting it. Often, these surveys are given to the servicemember to fill out 'for' the family. How many actual FMs filled them out? I question accuracy.

A recently deploying Service member said, "Everyone deploying has some level of PTSD; you can't help but be affected by the stress." And so it goes for employees, active duty and our civilians, left back in Garrison to 'cover down' and support the families of those in the combat zone. Depression and anxiety exit across the board. Deployed Reservists would be more likely to have suicidal ideation and attempts than active-duty personnel as their families are worn out from sustaining the repeated separations, especially without the military base or post around to support them. I believe divorce stats parallel suicide rates, as broken relationships are so common to 'the last straw.' We all know relationship issues are a key component to loss of life due to suicide.

Limitations of the study: Self-reported data? Absolutely! Low response rates? Absolutely. And who were the ones who did respond? Was there a self-selection present? Likely they were the most mentally fit with the energy to respond and the least to lose! 

The Conclusion? "Future research should aim to identify services and interventions for reservists in order to help them with post-deployment mental health issues." Again, absolutely, but we don't need more "research" to discover what services are needed, just ask the end-users themselves...right now, and instead use 'research dollars' to provide the support we say we are providing already!

About the Guest Columnist:

patrinDr. COL (Ret) George Patrin, MD, FAAP, FACHE spent over 23 years as an Army Pediatrician and Healthcare Administrator concentrating on Family Advocacy and Healthcare Process Improvement. His final assignment was as Northern Regional Command Special Projects Officer for Patient-Family Centered Healthcare assisting in writing DoD Patient Centered Medical Home (PCMH) Guidelines and Training. He has been a staunch advocate for both soldier and family member readiness throughout is military career. He is a sought after speaker on parenting education, child abuse prevention, school learning and behavior problems, and healthcare administration optimization. He can be contacted at patrin.george@gmail.com.

 

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