The military mental health system falls far short of troops' needs, watchdog report shows

Elizabeth Howe
August 17, 2020 - 1:14 pm
Mental Health

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More than half the active-duty troops and family members who need mental health services from the Military Health System are not getting it, a Pentagon report says.

A Department of Defense Inspector General report published last week shows that this is just the beginning of the Military Health System's shortcomings when it comes to providing mental health services to those active-duty troops and family members who require it. 

"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," the report reads. 

Of the 13 military medical treatment facilities (MTFs) investigators checked, seven did not meet specialty mental health access to care standards. And an average of 53% of all active-duty service members and their families identified as needing mental health care and referred to the care system did not receive the referred care. The MHS did not have data available as to why. 

The MTFs lacked the processes required by law to ensure patients receive follow-up treatment -- meaning the patient’s follow-up treatment may have been delayed or did not occur at all. The DoD:

  • Published inconsistent and unclear access to mental health care policies;
  • Did not have visibility of patients who attempted, but were unable, to obtain mental health appointments in the purchased care system;
  • Measured the 28-day specialty access to care standard differently between the direct and purchased care systems, both of which included only those patients who were able to get an appointment, excluded patients who self-referred, and considered only the patients’ first appointment.

As a result, the report concluded that thousands of troops and family members may have experienced delays in obtaining mental health care or not have received it at all. 

The report made 14 recommendations that could be implemented including to update memorandums, remove the eight-visit limitation for outpatient mental health care, develop a single MHS-wide model to identify appropriate staffing levels, update DoD and DHA policies, develop a method to book patient appointments, and develop standardized mental health access to care measures. 

In 2018, 541 service members across the military’s active and reserve components died by suicide. In 2017, the first year for which this data is available, 123 military spouses and 63 dependents died by suicide.

“The department is committed to the well-being of our military families and ensuring families are best equipped to support their service members and each other,” Karin A. Orvis, director of the Defense Suicide Prevention Office said when the most recent DoD suicide reports were released. “We will continue to pilot and implement initiatives focused on increasing family members' awareness of risk factors for suicide to help our military community recognize when they are at risk so they seek help."

If you or someone you know needs help, contact the Veteran Crisis Line 24/7 at 1-800-273-8255 (select option 1 for a VA staff member). Veterans, service members or their families also can text 838255 or go to veteranscrisisline.net.

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