Army Leaders: Long-Term Mental Health Care Needed

Army commanders said they expect more soldiers to struggle with mental health problems as deployments to the Middle East become more rare.

Many Fort Bragg soldiers have been in a decade-long cycle of deploying to war for a year, then coming home to train for another deployment the next year.

But with the Iraq war over and the Afghanistan war scheduled to end in 2014, that cycle is coming to a close. The entire 22,000-soldier 82nd Airborne Division is back at Fort Bragg, and only 2,000 of those soldiers will see another deployment to Afghanistan.

"We'll have more of our soldiers back, and those soldiers will have more time at home to realize all is not well," Brig. Gen. Timothy P. McGuire, deputy division commander, said Thursday at a conference focused on mental health in the military. "In terms of seeking help, I think you'll see an increase in demand."

McGuire was one of a half-dozen high-ranking soldiers speaking to more than 200 psychologists, social workers and other professionals at the third annual Forward March Conference.

The two-day conference -- created by the Partnership for Children of Cumberland County, Southern Regional Area Health Education Center and Snyder Memorial Baptist Church -- brings together military and civilian leaders and experts to discuss with mental health professionals and others in related fields how years of war affect soldiers and their families.

The expected increase in demand will challenge an already taxed mental health system.

At an afternoon panel discussion, leaders of military, veteran and civilian mental health services said they have already seen a spike in their caseloads.

But reforms in the state's mental health system could mean the money available for mental health care could decrease even as demand increases.

The Veterans Affairs Medical Center and Womack Army Medical Center are not facing such budget cuts, and they are part of larger efforts to change the way mental health care is delivered.

Both hospitals are more closely aligning mental health care in offices alongside primary health care. Part of the idea is that it's more convenient and less embarrassing to speak to a psychologist during a doctor's visit than going to a separate psychologist's office. Mental health issues can also be an important factor related to physical problems that would be treated by a doctor.

"There was a time not too long ago that primary care was in one building, mental health was in another building, and, God forbid, they ever get together to talk about the same patient," Fayetteville VA Director Elizabeth Goolsby said.

At Fort Bragg, every brigade will soon have its own mental health team embedded as part of the unit.

Maj. Gen. John W. Nicholson Jr., commander of the 82nd Airborne Division, asked for the community's support as the nation winds down the longest war in its history.

"I think it's fair to say we don't fully understand the scope of the behavioral health challenges we face now," Nicholson said. "We have some learning to do."

Brig. Gen. Ferdinand Irizarry II, on the morning panel with McGuire, said the community needs to be prepared for a long-term commitment to treating soldiers and their families. Irizarry, deputy commander of the John F. Kennedy Special Warfare Center and School, noted that deployments would not stop for many of Fort Bragg's special operations soldiers. Experiences in war can have lingering effects that sometimes don't show up for a long time, he said. And those who aren't still deploying will face the added stress of what will likely be tougher promotion standards as the Army downsizes.

For leaders in the National Guard and Army Reserve, spotting their soldiers' problems can be a challenge.

Sometimes, leaders only see their soldiers one weekend a month during training.

"They can fake it a weekend a month," said Brig. Gen. Tammy Smith of the U.S. Army Reserve Command on Fort Bragg. "But you have a harder time faking it with the family. You have a harder time faking it at the workplace."

Smith encouraged family members who don't know where to turn for help to call a 24-hour service called Fort Family, which is designed to direct people to help near them wherever they live.

Command Sgt. Maj. Chris Faris, who travels the country speaking to special operations troops, said that despite the increased awareness and efforts to help, too many families still feel like they're alone. They don't see that others are struggling with the same problem, and they don't see that there's help available.

"They look around and go 'Gosh, what am I doing wrong?' " Faris said. "We're overcoming this through these types of discussions, but that's still the biggest thing we see out there after 11 years: 'I'm alone.' "

The conference continues today, starting at 8:30 a.m. at Snyder Memorial Baptist Church.

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