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Army works to improve mental health services
Fort Hood shootings focuses attention
post pyschiatrist 2
Maj. Chris Warner stands outside Winn Army Community Hospital on Fort Stewart where he is Chief of Behavioral Medicine. - photo by Photo by Denise Etheridge

In light of the Nov. 5 incident at Fort Hood, Texas, where Maj. Nidal Malik Hasan, an Army psychiatrist, is accused of shooting 13 people dead and wounding 29 others, questions have been raised about the Army’s ability to spot mental health problems among soldiers.
Although he said he could not answer questions directly related to the Fort Hood tragedy, Maj. Chris Warner, chief of behavioral medicine at Winn Army Community Hospital, did address the Army’s current approach to mental health.
 “We are committed to providing soldiers and their family members care,” the post psychiatrist said.
Warner said the Army is trying to expand mental health services for its soldiers and their dependents and make these services more easily accessible.
“Over the last year, we have doubled our clinical services here at Fort Stewart,” he said. “We have hired more psychiatrists and opened services to family members. We offer adult services and limited child and adolescent care.”
Warner said military members and their dependents also can find providers in the surrounding community through TRICARE.

“We want them to get help,” he said. “We want to make it easily accessible.”
The post psychiatrist also stressed the Army thoroughly screens its soldiers for medical and mental health problems before they deploy and when they return from a deployment.
If a soldier does not pass the minimal mental health criteria set by the Department of Defense, such as showing signs of bipolar disorder, psychosis or a change in medication (to keep them stable), they will not be deployed, he said.
Warner himself has had two deployments to Iraq; in 2005-06 and in 2007-08.
“In Iraq alone, we have 200 mental health professionals with boots on the ground,” he said.
These professionals work with the units to help prevent mental health issues among soldiers, Warner said.
Soldiers who are fit to deploy must complete a post deployment health assessment while “still in theater” before they return to the U.S., he continued.
“We look at medical issues, such as if they’ve been exposed to toxic substances, and we screen soldiers for signs of PTSD (post traumatic stress disorder), traumatic brain injury and depression,” the doctor said.
Warner said if a soldier is found to have medical or mental health issues then the system springs into action, to provide the care the soldier needs while still overseas, and to ensure follow-up care is provided upon his or her return.
“The process is repeated in the first 10 days a soldier is home,” he said.
Warner said the Army also has implemented a program to decrease “burnout” among its mental health providers.
Army mental health providers must complete a professional quality of life satisfaction survey, he explained. This tool measures a provider’s secondary fatigue, sometimes called compassion fatigue. A mental health provider may experience compassion fatigue after treating a multitude of soldiers who relay their traumatic wartime experiences in therapy. Should providers be experiencing difficulty themselves, they are trained to use self-management techniques, he said. Mental health providers also have mentors, so they always have another professional to turn to, Warner added.
Providers and other soldiers concerned about their privacy also can find mental health services off post through, he said.
“We are an Army under stress,” the post psychiatrist said, referring to the emotional duress soldiers and their families experience because of multiple deployments.
The Army has taken steps to alleviate some of the stress, he said, by encouraging soldiers to spend quality time “making memories” with their families between deployments. The Army also has programs to help soldiers and their spouses cope with separation by helping them strengthen their marriages.
“We have conducted research to understand their (military families) level of stress and what key things are stressing them and then we try to meet their specific needs,” Warner said.
He said the Army’s Battlemind System helps soldiers and military spouses understand what causes stress during transitions such as deployments.
Warner said the Army has begun to focus on preventive mental health care, such as the steps it has taken to prevent suicide. The most valuable help often comes from those who know a soldier best, he said.
“The No. 1 method to overcome the stigma (for seeking mental health services) is having family and friends encourage a soldier to seek help,” the doctor said.
Warner said he recommends the ACE method: ask if there’s a problem, care by listening to what is going on in that soldier’s life and escort a soldier to mental health services.
“Don’t ever leave them alone,” he advised. “Offer to go with them.”
Soldiers are now trained to recognize certain red flags that point to a fellow soldier’s mental illness, he said, such as sudden changes in behavior, the desire to carry weapons, expressing anxiety in crowded places or no longer doing the things that used to bring them joy.
The post psychiatrist said a soldier could be suffering from depression if they talk about being unhappy, say no one will miss them if they’re gone or give their treasured possessions away.
Warner said soldiers should not be ashamed to seek mental health services.
“It’s not a sign of weakness, it’s a sign of strength,” he said.

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