Mental health providers need training

Jacey Eckhart

CincHouse.com

A few months ago I was in the middle of an interview with a therapist when she popped out with a notion I could not believe.

“I just feel so sorry for you military wives,” the therapist mused. “Your lives are not your own.”

“I beg your pardon,” I said, looking up from my notebook.

“You wives. You aren’t living your own life. You’re really living his life.”

I didn’t think the woman was certifiable. By the diplomas on her wall, I would have said she was certified — a state-licensed, trained, experienced marriage and family therapist. So why was she such an idiot?

It occurred to me that maybe this was one of those psycho tests, that the therapist wanted to see whether I’d agree to such a statement. But she bristled when I explained how I choose my military guy every day. That I can move or not move. That there are careers and lives that don’t depend on living in one location.

The therapist shrugged and made a little moue of disagreement. I knew in that moment I was fighting a losing battle, so I shut up. Rare for me. But I pondered this all the way home. How can an educated person like a therapist be so woefully ignorant about military life? How much damage does it do to have an authority figure like a therapist hold such unhelpful ideas about our culture? I

s this the kind of unseen, unstudied thing that keeps our military and their family members from seeking therapy?

Maybe.

I found myself thinking about that therapist again a few weeks ago when the RAND corporation issued a report about the invisible wounds of war. In addition to the usual numbers about how many service members return from Iraq or Afghanistan with PTSD or depression, the authors of the study also concentrated some thought on the quality of the services provided.

They found that only 53 percent of service members with symptoms of PTSD or depression sought help from a provider over the past year, and of those who sought care, roughly half got minimally adequate treatment. That’s only about a quarter of the people who need care actually getting good care. No wonder the researchers found an urgent need to train more mental health providers on delivering evidence-based treatments that actually work.

When I talked to Lisa Jaycox, senior behavioral scientist at RAND and coauthor of this study, she told me that the quality of the provider was also important.

“Service members and veterans should be getting care from someone who understands state-of-the-art treatment, but also someone who understands military culture and the unique aspects of that lifestyle.” I’m all for that. In addition to being trained in cognitive behavioral therapy, it seems obvious to me that anyone who is going to treat our service members or their families should also be required to undergo training to understand our culture.

I’m not talking about teaching them all the words to the Marine Corps Hymn. I don’t demand that they be able to identify a sergeant major at 600 paces. I’m just saying they should have some kind of understanding of what it takes to be a sergeant major. That they should be familiar with how many different career paths there are in military life.

They should be able to recognize what motivates people to be in the military outside what they’ve seen in “Officer and A Gentleman,” or “Jarheads.” They should be able to identify what is normal for us and what is not. Moves are normal. Deployments are normal. Smacking people around when you get home is not.

When so few people serve in the military, it isn’t surprising that our providers have not served themselves or were not brought up in our military community. It’s no wonder they don’t always understand the subtleties of our culture. But that can be rectified. Require that providers go through a training program before they treat our people, before they are qualified and recommended, before they get paid.

Because we need our returning Soldiers and Marines to be able to trust in the quality of care available to them. We need them to come back to normal. We need each one of them and their family members to be running well on all cylinders.