FORT HOOD, Texas (Sept. 23, 2010) -- The Army needs a significant cultural change so Soldiers who need behavioral health services and treatment will seek care, Vice Chief of Staff of the Army Gen. Peter Chiarelli told Fort Hood's Health Promotion Council Tuesday at III Corps.
Wendy Lakso, III Corps and Fort Hood health promotion officer, said the council, an asset of Army Public Health, integrates medical, tactical and garrison assets on the installation to address public and behavioral health concerns.
Behavioral health is on the forefront of Chiarelli's mind these days. The toll on Soldiers and families of nearly nine years at war is manifesting in a number of ways.
The Army is seeing an increase in behavioral health issues such as depression and anxiety and, in extreme cases, high-risk deaths, suicide attempts and suicides, Chiarelli said.
Traumatic brain injury and post-traumatic stress are the "signature wounds of this war," the vice chief said.
Soldiers with TBI and PTS are becoming more prevalent as the war continues. More than 60,000 TBIs have been diagnosed since 2003, Chiarelli said. The Army Wounded Warrior Program has 7,556 Soldiers enrolled. Of those, 62 percent are suffering from PTS or TBI.
More than 216,000 active-duty Soldiers received outpatient behavioral health treatment in fiscal year 2009. Chiarelli said he is happy about that. In fact, he would like to see that number rise because it means Soldiers were seeking and receiving the help they need.
Not a disorder
Chiarelli believes post-traumatic stress is a chemical injury, not a disorder.
He does not like the stigma often associated with calling it a disorder. Some people can view PTSD as a weakness or a sign of weakness in a person, he said.
"PTS is real; it is an injury," Chiarelli said. "It should be treated as an injury."
The first step, Chiarelli said, is in helping to eliminate the stigmas about behavioral health and treatment.
Soldiers suffering from traumatic brain injury and PTS require treatment focused toward their injury, he said, the same way Soldiers with physical injuries receive care.
"No one is complaining about the way we are treating Soldiers who lose arms or legs," Chiarelli said.
Brain injuries are different from physical ones, he said, and brain science is more complicated than mending a wounded limb.
Soldiers with brain injuries can be more prone to high-risk behaviors and activities, he said, either because of the injury or out of frustration from symptoms.
Chiarelli wants TBI and PTS to be treated as medical conditions caused by injuries. He wants Soldiers to get the help and treatment they deserve.
"We have put many of these Soldiers in this position," Chiarelli said. "We owe it to them to make them well."
The Army needs a cultural change that encourages Soldiers at all levels to take advantage of available services and to ask for help when they need it, Chiarelli said.
Helping those with TBI or PTS begins with changing how the Army looks at brain injuries and their affects.
The first step is in recognizing that TBI and PTS are injuries.
"We've got a cultural issue," Chiarelli said. "We've got commanders today who believe Soldiers who get a concussion are not entitled to a Purple Heart."
From receiving entitlements to breaking the stigmas related to seeking help, the Army needs to change, the vice chief said.
"We've got to change the culture so Soldiers realize that they need to seek help when they need it," Chiarelli said.
The Army is working to start that change now.
A new Army video features Medal of Honor recipients speaking out and encouraging Soldiers who need behavioral health help to take advantage of available services and ask for help. All of the Medal of Honor recipients have either TBI or PTS.
The vice chief hopes that Soldiers hearing the "seek help" message from America's heroes will encourage Soldiers to get the help they need.
Chiarelli said engagement by leaders, NCOs and Soldiers at all levels is vital.
"Keep an eye out for your buddies and Soldiers in the units," the vice chief said.
That battle-buddy mentality and engagement at all levels seen during deployments cannot stop when Soldiers leave the combat zone, he said.
"That same attention should apply in garrison," Chiarelli said. "We need to ensure all are aware of threats and resources."
He wants leaders to know their Soldiers and recognize the signs of high-risk behaviors. Chiarelli said commanders need to ensure their unit is an environment that encourages Soldiers at all levels that need behavioral health help to seek it.
When it comes to engaged leadership, Fort Hood leaders said Chiarelli is showing the way by putting behavioral health issues up front.
"General Chiarelli is leading our Army from the front as we work together to combat the cumulative physical and psychological effects in this era of persistent conflict," said Maj. Gen. Will Grimsley, Fort Hood senior commander.
Chiarelli attended the monthly Health Promotion Council to address Fort Hood senior leadership, brigade commanders, command sergeants major and agency heads to raise awareness about behavioral health concerns and engage leaders at all levels.
"He knew this would be a good forum to brief the subject because everyone is here," Lakso said.
The vice chief's visit was appreciated at all levels at Fort Hood.
"It is always great when the vice chief takes time to visit The Great Place and address our senior leadership," Grimsley said. His leadership on the Suicide Prevention Task Force and his commitment to quality care and treatment for our most vulnerable is evident in everything he says and does."