Meredith is a military spouse, mother, educator and writer currently living in El Paso, Texas. Her short stories and writing on travel, parenting, military life and pop culture have appeared in various publications. She can be found at www.meredithflory.com and on Twitter at @MeredithFlory.
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This past year, my husband, a noncommissioned officer, reenlisted for indefinite service until retirement. After being pinged around the United States for 11 years, we received assignment instructions to our dream place: Germany.
We sold our RV and truck, cleaned out our house, prepared our kids, and listed our house for sale. It went under contract almost immediately.
But I was nervous about the overseas screening process.
Over the past year, I sought help for anxiety, utilizing non-medical counseling. My referral to an off-post licensed professional counselor (LPC) was captured in my medical records. As a result, I was told I was required to enroll in the Exceptional Family Member Program (EFMP), a program we had no experience with and that provided very few answers to our questions.
Due to staffing shortages, my doctor could not even process my enrollment. Instead, a physician I had never seen before did it. We heard from other military families and military staff that it was not a big deal, that my needs were minimal and we were being sent to a European country with medical facilities.
Still, I was concerned that my anxiety diagnosis would cause a problem. Over and over, I heard not to worry and that I had done the right thing. Sadly, I was right.
Good thing I made sure we had a contingency plan on our house contract in case things changed, because two months after beginning the overseas screening process, we received an email from a family travel clerk that our family travel was denied and my husband's orders would be processed, sending him to Germany alone. The reason started, in all caps:
"FAMILY TRAVEL DISAPPROVED BECAUSE THE APPROPRIATE OFFICIALS HAVE DETERMINED THAT SPECIAL MEDICAL CARE REQUIRED BY SOLDIER'S FAMILY
MEMBER(S) IS NOT AVAILABLE IN THE EUROPEAN THEATER."
The only "special care" I receive is elective counseling. I do not see any other specialists or have other ongoing health problems. I had been denied travel because I sought behavioral health care in the States, and they do not have behavioral health available for incoming families.
The military's answer for a spouse who had gone to counseling due to separation from family, deployments, giving up her own career and parenting through a pandemic was to …
Make her parent alone again.
May is Mental Health Awareness Month, so of course, military social media and on-post organizations have started touting resilience, fighting the stigma of mental health issues and access to resources.
In theory, this messaging is wonderful. Unfortunately, military messaging on mental health rarely aligns with practice.
Should I Appeal the Decision for My Mental Health?
I am a writer, an educator with a master's degree, a mother to two, and a military spouse who is active in her community. I also have anxiety attacks.
All the Army seemed to focus on as we were forced to surrender our dream posting was the last part.
We could appeal in six months, but not appeal the decision. We'd be fighting to prove that my medical situation had changed, not that the original decision was flawed, and it took us hours to even find information on the policy and answers to our questions. If we chose to appeal, my husband would still have to leave for Germany before we knew whether our family could join him, making me go through the process and possible international move alone.
It didn't matter that within 48 hours of the Army's email we had found a counseling office in Germany on our own, willing to take me as a new client within a month of getting there, that spoke English and was covered by Tricare. The EFMP office said they didn't have to talk to us, share information, or listen to any work we had done to find our own care. Their decision was made.
I posted online about it and received attention from Army leadership saying they would help. The help amounted to reading my email and saying, "We'll pass the complaint along."
My husband's chain of command helped him get out of the orders, so we can at least stay together, but my enrollment in EFMP over a common diagnosis will now affect every single assignment he has left. Taking care of my mental health feels like it will limit my husband's career. We've been advised to never request an overseas duty assignment unless I stop all mental health care. So the military has decided that I have to choose between taking care of myself or knowing my family can make a permanent change of station (PCS) move together.
Sending Mixed Messages About Mental Health
With long wait times for behavioral health care across the U.S., my family may not be able to move together until retirement. After speaking publicly about my situation, I've heard from many families faced with these choices regarding PCSing and mental health. As a result, some families have decided not to seek help.
Instead of fighting the stigma, the Army is driving those in need underground. The message I am hearing is that military spouses should just keep their mental health needs to themselves.
As anyone with anxiety, depression, post-traumatic stress disorder or similar diagnoses may have experienced, there are waves when you are your best self, and waves where you need more support. I was nervous whenever I approached counseling or medication that it might be a problem for military life, but over and over, my husband and his chain of command assured us that mental health was important, private and I could use Tricare for assistance without it ever being a problem. In fact, his job is so stressful, that a mental health professional is located within his office for the staff to use. But it feels like the focus on mental health and resiliency doesn't apply to families.
The military knows this is a problem. An Inspector General report released in August 2020 found that, "The DoD did not consistently meet outpatient mental health access to care standards for active duty service members and their families, in accordance with law and applicable DoD policies." This, combined with strict EFMP enrollment requirements, means fewer and fewer options for families with a mental illness diagnosis.
Mental health care is health care, preventative and common! The military should be working to have counseling available through internal hiring, strengthening community partnerships and telehealth. Spouses shouldn't have to choose between duty assignments, staying with their spouse, and care that can help them be their best selves to enjoy the few and very far between perks of this life.
Furthermore, the overseas screening process and EFMP enrollment should not be shrouded in secrecy and shame. I've yet to see a single way this program benefits us. Instead, the policies vary by location and service branch. I should have been informed about this process the minute I received a diagnosis at a military medical care facility, not after we had started following our PCS assignment instructions.
Now, each year my husband goes through the Army's PCS selection process, we will hope I'm allowed to go too -- because EFMP does not tell you ahead of time which places are possible with certain diagnoses. This uncertainty is stressful to fathom for the remainder of his career. Disenrollment is also a complicated and lengthy process.
If my experience is indicative of the average experience, EFMP needs an overhaul. If it is the exception, resources to help deal with the process need to be more transparent and available. This is particularly vital when it comes to mental health care and the Army's messaging about the importance of mental health.
Without an EFMP overhaul, Mental Health Awareness Month will continue to be recognized as simple lip service for military families.