The Defense Department is weighing the option of cutting thousands of uniformed medical personnel, including psychologists and other mental-health professionals, even as military leaders grapple with rising suicide rates among troops.
With the National Defense Strategy pushing for a more lethal force, Pentagon leaders are considering slashing as many as 17,000 uniformed medical corps billets across all the services.
The move, which could go into effect in October 2020, would open more slots for troops in combat-arms specialties or other warfighting jobs.
Thousands of those uniformed personnel serve as psychiatrists, social workers, psychologists, counselors and nurses. And, as the number of active-duty troops taking their own lives reaches a six-year high, military advocates say now is not the time to consider cuts to those fields.
"Suicide and mental health are our top priority at [Iraq and Afghanistan Veterans of America] because of the serious impact these issues are having on our community," said Jeremy Butler, the new chief executive officer for the organization, which represents and advocates for post-9/11 vets. "I am concerned about any cut in resources signaling that DoD is not making these matters as high a priority as we do."
Military officials stress that there is no immediate plan to cut those billets, though the review to trim the size of the overall medical corps is ongoing.
"Any reforms that do result will be driven by the Department's efforts to ensure our medical personnel benefits that service members, retirees and their families deserve," said Angel Lopez, a spokeswoman for the Air Force surgeon general.
Ed Gulick, a spokesman for Navy Medicine, said about a quarter of the Navy Department's 1,600 mental-health personnel are embedded with the Navy and Marine Corps fleets, and they hope to expand the program.
"Navy Medicine has found that embedding mental health providers directly into Navy and Marine Corps operational units has had a powerful effect on decreasing stigma and making care more accessible to our service members," he said.
Just waiting for sailors to get help at a hospital or clinic is a barrier to care, said Capt. Tara Smith, with the Navy's Suicide Prevention Branch. Embedding providers at the unit level moves the care closer to the troops in need, she added.
Still, suicide remains a serious problem across the active-duty force. Last year, 321 active-duty troops committed suicide, marking a six-year high. Fifty-seven Marines, 68 sailors, 58 airmen and 138 soldiers took their own lives.
Despite efforts by military leaders to end the stigma that seeking help with mental-health problems will derail your career, problems still exist, said one wounded combat veteran. Since he currently works for a veterans service organization, he spoke on condition of anonymity so as not to appear to be advocating for changes to the medical corps.
While there are benefits to talking about military-related stressors with someone else in uniform, he said there's still the fear that it will later be used against you, which leaves some seeking help outside the military.
"That perception that it's going to affect your career is still real," he said. "And to be frank, I don't think the services know how the hell to fix the issue as it relates to mental health and suicide."
Service leaders say they remain committed to ending that fear. Chief of Naval Operations Adm. John Richardson told reporters last week that leaders will continue to try "every trick in the book to try and get this under control."
"It's such a difficult problem," he said. "... The [programs] that show the most hope are those where we really get down to small-unit cohesion so that our sailors all feel like, no matter what the situation they may be confronting -- a professional challenge, a personal challenge, whatever, that they are part of some kind of a team."
The Air Force, which Lopez said currently has about 1,600 uniformed mental-health professionals, is working toward an end goal of never losing another airman to suicide. Its suicide-prevention program is designed not only to provide maximum support to airmen and their families, but to commanders leading their troops as well, said Brig. Gen. Michael Martin, director of Air Force Integrated Resilience.
"It is about a culture of care and respect established by commanders and senior enlisted leaders that arms airmen at all levels with the training and tools for the decisive edge when their wingmen are in crisis," he said.
As the 2020 budget-planning process, which will decide the outcome for the number of billets the uniformed medical corps will see in the year ahead gets under way, Gulick said the goal is to balance support for the National Defense Strategy while also being responsible stewards of taxpayer dollars.
"Our priority remains to ensure our medical personnel are trained, equipped and ready to support the operational forces, while delivering outstanding care to our beneficiaries as we maximize our military and private-sector care network to provide timely access to great care," he said.
-- Oriana Pawlyk contributed to this report.