By PAULINE JELINEK, Associated Press Writer Wed Apr 30, 2008
WASHINGTON - U.S. troops won't have to reveal all their mental health counseling when applying for security clearances under a change the Pentagon hopes will ease the stigma of seeking help for combat stress, The Associated Press has learned.
Defense Secretary Robert Gates plans to announce the new policy Thursday, according to several defense officials.
Thousands of troops are coming home from Iraq and Afghanistan with war-related anxiety, depression and post-traumatic stress. But many hesitate to get psychiatric care because they fear that could cost them their security clearances, harm their careers and embarrass them before commanders and comrades.
Gates is trying to remove one impediment, revising a question about mental health treatment that appears on the form required by the Office of Personnel Management, the agency that does the majority of investigations for security clearances to military and civilian federal workers, officials said. They spoke on condition of anonymity because the announcement was pending.
Currently, Question 21 on the form asks applicants whether they have consulted a mental health professional in the past seven years. If so, they are asked to list the names, addresses and dates they saw the doctor or therapist, unless it was for marriage or grief counseling and not related to violent behavior.
The amended question Gates has approved is less stringent. It essentially means troops do not have to volunteer information about therapy they got for difficulties caused by their wartime tours of duty or other missions, said four officials familiar with the revision.
Because the revision is only for military applicants and the question remains unchanged for other federal employees, the form hasn't been altered. Defense applicants will receive a packet including the application, the substitute question and a memo explaining the change and encouraging troops to seek treatment, three officials said.
The Pentagon says the perception of stigma for security applicants is far worse than the reality.
The most recently released data show less than 1 percent of some 800,000 people investigated for clearances in 2006 were rejected on the sole issue of their mental health profiles.
The investigation weighs a number of factors about the applicant, favorable and unfavorable, officials say. Troops can be rejected for a clearance if they've been convicted and imprisoned, are addicted to any controlled substance, have been discharged dishonorably from the service or are mentally incompetent.
Up to 20 percent of the more than 1.6 million who have served in Iraq and Afghanistan are estimated to have mental health problems, the Defense Department says. Though officials haven't released the number of troops diagnosed, a yearlong private Rand Corp. study estimated that roughly 300,000 may be affected.
Successive government and private studies have found roughly half of those who need help are seeking it.
The Department of Veterans Affairs says that about 120,000 of the 300,000 Iraq and Afghanistan vets it has seen for various injuries and problems have been diagnosed with symptoms of mental health difficulties.
Revising the security clearance procedure is just the latest in a string of efforts aimed at changing military attitudes on mental health:
• The Army last year held special sessions to teach 800,000 troops how to recognize concussions and mental problems in themselves and their buddies.
• The Army and Navy have put mental health professionals into primary care centers — rather than setting them off in separate locations — so troops can go for appointments discreetly.
• The Navy is quadrupling to 30 from seven the number of special mental health teams embedded with Marine Corps units.
"What we are finding ... is that if we embed mental health professionals with our men and women on a daily basis, stigma goes down," the Navy's surgeon general, Vice Adm. Adam Robinson, said in response to an e-mail query. "This is because the mental health professionals become part of the unit. They become your friend in the mess hall that you see around that makes them more accessible."
Officials say they see signs the stigma has been slowly easing over the years, though it's still believed to be worse among those who need treatment.
Last year, 29 percent of troops in Iraq who had symptoms of mental problems said they feared that seeking help would hurt their careers, down from 34 percent the previous year, according to an Army survey of more than 3,000 people.
Nearly half said they would be seen as weak, down from 53 percent the previous year, and nearly 52 percent feared members of their unit might treat them differently, down from nearly 58 percent.
The majority of troops who get help are able to get better and to remain on the job.
The overwhelming majority of troops and their spouses recognize that mental illness can be successfully treated, according to a survey released Wednesday by the American Psychiatric Association, done online and from a much smaller sample size of about 350 people.
Still, many resist counseling until their symptoms worsen. Some go secretly to civilian therapists and pay for it themselves rather than going to military counselors.
"There's a pride and a bravado," said 1st Sgt. Andrew Brown, an Army reservist of Harrisburg, Pa., who has been diagnosed with post-traumatic stress. "The feeling is that you are going to tough it out, cowboy up, get it done, suck it up — all the catch phrases that we teach young soldiers."
Ending up with nightmares, flashbacks or uncontrollable fear can be hard to square with that self-image.
Dr. Paul Ragan, an associate professor of psychiatry at Vanderbilt University, saw one side of the problem in his days as a Navy psychiatrist at a military psychiatric ward.
"I can't tell you how many times I heard from a gunny sergeant or a major who said, 'Look this guy's just weak, he just needs a kick in the rear,'" said Ragan, who retired from the military in the 1990s but still treats veterans as a civilian.
While that philosophy still exists to some extent, more commanders in today's military are trained to be able to spot mental problems, said Brown, who speaks on the issue for the Iraq and Afghanistan Veterans of America.
"Young soldiers carry a lot of baggage, thinking 'combat is glorious and heroic,' or 'I'll be the first kid on my block to have a terrorist kill under my belt,'" he said.
On the Net:
National Security Questionnaire: http://www.opm.gov/forms/pdf_fill/sf86.pdf
Army battlefront survey: http://tinyurl.com/38zfmq