Forbes: Military Spending Restricts Mental Health Measures

NYAPRS Note: The failure of the House of Representatives to include essential preventive, assessment, and public health-oriented measures in the revised NDAA last week undermines valuable national mental health initiatives. The impetus of mental health parity, and behavioral health integration through Medicaid expansion, is to reduce the need for emergency behavioral health treatment due to lack of engagement or proper assessment. These initiatives should be reflected through a similar commitment from National Defense authorities and spending. The military must better coordinate attention to mental health and trauma both during active service and after deployment, if it hopes to truly support the well-being and needs of its service men and women.


Mental Health Measures Removed From New Military Spending Bill

Forbes; Rebecca Ruiz, 12/20/13


When the House of Representatives recently passed its version of the National Defense Authorization Act, it contained measures to address serious concerns about the diagnosis and treatment of mental illness in the military.

Most importantly, it included an amendment for the creation of a commission to evaluate claims that soldiers with combat-related psychological distress and traumatic brain injuries are being kicked out of the military due to minor infractions. I wrote about that a few months in a post that looked at the Colorado Springs Gazette’s investigative series on this topic.

The commission would have evaluated those charges and determined what, if any, policy changes need to be made in order to account for the role of combat-related mental or physical illness in a soldier’s misconduct.

But when the Senate passed its version of the bill on Thursday night, that amendment had been scrubbed. Two other mental health amendments had been stripped as well:

  1. Mental health assessments: The law would have provided regular mental health screenings for all active-duty service members. Currently, the focus is on giving these assessments to service members who deploy, and even then, the requirement can be waived if an individual isn’t exposed to “operational risk factors.”
  2. Mental health support for personnel and families: This provision is vague, but it would have permitted the Secretary of Defense to create initiatives that “respond to the escalating suicide rates and combat stress related arrest rates” of service members; train soldiers to recognize and respond to combat stress disorder, suicide risk, substance addiction, risk-taking behaviors, and family violence; and determine the effectiveness of the military’s efforts to reduce suicide rates.

These changes can be viewed in the explanatory statement about the bill’s original and final versions, but the document doesn’t contain information describing why these measures were removed. I’ve attempted to reach members of the Senate and House Armed Services Committees for comment, but have not yet heard back. A spokesperson for Sen. Carl Levin (D-Mich.), chairman of the Senate Armed Services Committee, told me that committee staff members had left for the holidays.

The NDAA did include some legislation regarding mental health, including an amendment that would help service members with post-traumatic stress participate in clinical trials for treatment outside of military facilities. Another measure enhances efforts to prevent suicide amongst reservists.

These are both very important amendments, but removing the others seems counter to the Defense Department’s emphasis of late on reducing the stigma of mental illness in the armed forces and ensuring that every service member has access to mental health care.