The Army Peers Inside Its Minds…

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The long-awaited Army Task Force Report on Behavioral Health, here, came out late last Friday. This was the report on the alleged mis-diagnoses of post-traumatic stress disorder among troops at Madigan Army Medical Center, the hospital at Joint Base Lewis-McChord in Washington state.

What is striking to me is the lack of a smoking gun.

I found no villains here.

There are no allegations of psychiatrists trying to downplay PTSD in order to save the government money, despite political pressures to do so.

There are criticisms of the system that have already been detailed before in previous reports:

— Problems with the new integrated disability evaluation system (IDES).

–Not enough providers, especially in rural areas.

–Inadequate training for civilian providers in how to document PTSD.

— Siloed systems of care and counseling.

— Problems with coordination of mental-health care on each installation.

It is easy to document the problems in the military behavioral health system. It is much harder to implement recommendations designed to fix them.

For example, a key recommendation is having a behavioral-health clinical coordinator at each installation. That’s also not a new idea. The 2005 Mental Health Task Force Task Force report urged essentially the same thing. But it’s hard to do when the medical and behavioral health systems in the military is so strained by a decade of non-stop combat.

Overall, as a professional, I consider the report very useful. It clearly illustrates – again — the enormous challenges left in war’s wake.

Army Lieut. General David Perkins, who directed the study, closed its executive summary like this:

Finally, the Army must plan ahead to manage the requirements for behavioral health and the IDES for the next war. The Army should develop planning factors and decision support tools now for implementation at the very beginning of the next conflict. These planning factors are necessary to adequately predict sufficient resources and proactively manage the assessment, treatment, and processing of Soldiers with behavioral health conditions. Perhaps the lesson best learned by the Army from this past decade of war is the importance of proactively preparing for and addressing behavioral health and IDES concerns.

Let us remember those words, before we go to war the next time.