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Mark C. Russell, Ph.D., ABPP Headshot

Best Way to Honor America's Veterans: End the Cycle of Mental Health Neglect, Stigma and Crisis

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For the 93rd year since the November 11, 1919 commemoration of "the war to end all wars," the American nation once again pays customary homage to its fallen heroes and the 24 million veterans alive today. Parades, political speeches, presidential laying of wreaths, purchase of flags, and a plethora of media specials on the military all reflect ritualized symbols intended to demonstrate societal appreciation for the many sacrifices made by members of the warrior class.

Veteran's Day or National Groundhog Day?

On November 11, echoing across American cemeteries, national monuments, city halls, and television consoles, a million impassioned promises are made by politicians and representatives from military and veterans' agencies, who in unison pledge, "We will never forget those, who have sacrificed so much!" Speech after speech reaffirms the government's obligation to care for the visible and less visible wounds of war, typically by concluding with Lincoln's 1865 Inaugural address, "To care for him who shall have borne the battle and for his widow, and his orphan." And on November 12, the patriotic-sounding discourses are neatly folded and filed away for another year as the iron curtain of collective amnesia descends again over the national landscape. For when it comes to investigating the causes of this and every generational crisis of military mental health care, out of sight is truly out of mind.

Honoring Veterans by Ending the Cycle

In short, the single best way for national leaders to genuinely honor the sacrifices of veterans and their families on November 11, 2012 is to step up and end the cycle of mental health crises that have plagued American society since 1919 -- by investigating and eliminating the reasons why well-documented psychiatric lessons of war have repetitively been ignored with similarly tragic, yet entirely predictable, outcomes. If there is even a remote chance of ending this costly pattern, the decision to investigate has to be the proverbial "no brainer" -- doesn't it?

Walking the Walk: Investigating Repeat Failure to Learn Psychiatric Lessons of War

Ever since returning from deployment in 2003, I began reporting to the top brass urgent actions needed to avert the impending mental health crisis (e.g., significant increase in mental health staffing) -- a crisis caused largely by a massive failure to heed the most fundamental of psychiatric lessons of war in terms of planning, preparation, and training. Finally, in December 2005, three years after an estimated 23 written communiques and a rapidly escalating mental health crisis, I felt morally and ethically compelled to file a Department of Defense (DoD) Inspector General's (IG) grievance against military medicine. Instead of hiding behind the autonomy of the IG complaint process, the grievance was widely disseminated and followed with a 2006 public lecture "Broken Promises: The Untold Story of Military Mental Health Care." References to a "perfect storm" was captured by Stars and Stripes news reporters and repeated by USA Today, thus marking the beginning of the end to a once-promising military career.

Long story short, my family and I made the conscious moral decision to sacrifice a desired promotion and cushy 30-year retirement pension, for the sake of preventing known harm to this and future generations. However, the 10-year solo campaign to fix mental health care often seems like a giant exercise in futility -- perhaps it's time to stop and smell the roses?

Sense of National Urgency

Unfortunately, perpetuating these cycles of military mental health care crises is the tendency for the American military and society to hit a "national reset" button when it comes to learning the psychiatric lessons of war. Consequently, as the 2014 Afghanistan War draw down nears, the window of opportunity narrows for investigating and fixing the problem -- neither history nor time is on our side!

November 17, 2012 -- The Birthing of the Institute of War Stress Injuries and Social Justice

Therefore, on 17 November 2012, the Institute of War Stress Injuries and Social Justice will be publicly launched at Antioch University Seattle, Washington, with its first advisory board meeting. The laudatory mission of the Institute is twofold: (1) Investigate, identify, and eliminate root causes for repetitive crises in military mental health care, and (2) end the cycle of crises by transforming mental health care policy and practice. A last-ditch team effort to salvage a sinking ship before the national reset.

Why Social Justice?

Each year, thousands of young men and women join the military by signing a sworn contract to "protect and defend" others by subjugating themselves (and their families) to obey all lawful orders even if that means sacrificing their own lives, limbs, and mental health. In return, American society vows to ensure access to the highest quality physical and mental health care. No false expectations that veterans can be fully restored to pre-war health status, just that they receive maximum care possible. However, when well-known "psychiatric lessons of war" are frequently ignored, and basic mental health needs are repetitively neglected, this is a betrayal of the sacred trust and thus epitomizes injustice.

The moral equivalent to military medicine would be preparing for surgical needs in war by supplying hacksaws and a biting stick. Moreover, it is morally incumbent on a just society to honor our pledge to so few asked to sacrifice so much, especially when the majority are young members from less privileged backgrounds, with little power or voice in the public narrative. Social justice is also at heart when one considers ending the stigma, neglect, gross disparity and inequalities evident between mental and physical health -- all of which contributes to exorbitant costs and unnecessary suffering.

What Actions Can I Take to Honor Veterans?

The following views do not represent Antioch University or the institute, but are expressed solely as Mark Russell, private citizen and fretful father of two active-duty enlisted sons, both already war veterans. Please contact the president and our congressional representatives to urgently request:

  • Independent investigations into the cause of the current military mental health care crisis, especially in regards to ignoring psychiatric lessons of war, and what must be done to end the cycle.
  • Establish a unified "Behavioral Health Corps" within the Department of Defense commensurate with existing medical, dental, legal, chaplain, and nursing "corps."
  • Lift the promotion ban on military psychotherapists (clinical psychologists and social workers) to the Flag and General Officer levels, so they participate in war planning and preparation to ensure learning psychiatric lessons of war.
  • End VA and military hiring restrictions of licensed marriage and family therapists, mental health counselors, and clinical psychologists from non-APA approved training programs to address chronic staffing shortages.
  • Establish "Joint Services Behavioral Health Lessons Learned Center" program and policies similar to existing military and medical lessons learned systems so that psychiatric lessons are never again ignored.
  • Compel the VA and military to ensure every veteran has access to all evidence-based therapies per the VA/DoD (2010) PTSD practice guidelines including EMDR, and end the EMDR research ban.

Reference

Russell, M. (2006) Request for Expeditious Review of 28 Dec 2005 Formal Inspector's General (IG) Fraud, Waste, and Abuse (FWA) Complaint Submitted by Commander Mark Russell, MSC: Complaint Number 98829. Official grievance filed with the DoD Inspector's General Office on 5 January, 2006 entitled "Mental Health Crisis in the Department of Defense." Available upon request via Freedom of Information Act (FOIA) at Department of Defense; Office of Freedom of Information, 1155 Defense Pentagon; Washington, DC 20301-1155.