Posted on Jan 15, 2021
Re-evaluating the Role of Mental Health in the Military Discharge Process
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In recent years the topic of military discharge has entered the public spotlight with the role of post-traumatic stress at the core of the discussion.
Though mental health is required for consideration during the discharge process, recent media accounts criticize the extent to which mental health considerations are actually weighed. Research indicating that post-combat mental health issues can be a significant factor in bad conduct that leads to discharge has underscored the importance of mental health within the discharge process.
Mental health issues that develop as a result of war, such as post-traumatic stress (PTS), depression, anxiety or a combination of these issues, culminate in a number of behaviors that can lead to destructive conduct if gone unchecked. According to the Anxiety and Depression Association of America, symptoms of PTS that are often precursors to or agents of reckless actions can include irritability, aggression and impaired rationality. As many are aware, mental health struggles may also lead individuals to self-medicate with drugs or alcohol which present their own additional set of behaviors and challenges.
Marine Chief Warrant Officer Cooper Williams has made headlines lately for his fight to stay in the Corps following a potential discharge related to several DUIs. Williams, who struggles with PTS and a traumatic brain injury after surviving an explosion, used alcohol as a means to cope with war-related PTS that emerged on top of his parents’ murder-suicide.
BMC Psychiatry conducted a five-year study of Marines that found those with PTS or other psychiatric conditions were more likely to have a drug-related discharge compared to service members who did not experience similar mental health setbacks.
Alcoholism and drug addiction obviously play a significant role in determining the quality of an individual's overall mental health and as such, should be taken into consideration as valid setbacks when members are evaluated for discharge. These types of diseases should not simply be considered untoward or irresponsible behaviors, but instead should be seen in the bigger picture of other mental health struggles, like PTS, and subsequently be met with treatment instead of discharge.
Though the addition of a mental health evaluation in the discharge process in 2014 is certainly a necessary and positive step toward reaching an accurate and appropriate conclusion concerning an individual’s discharge classification, it currently benefits veterans in their attempts to change their discharge status after they have left the service. Unfortunately, it does little for active duty members, like Williams, as they wade through the process of attempting to remain on active duty.
In light of this, mental health conditions, including alcohol and drug addiction, that emerge and sometimes go undiagnosed during an individual’s military service should be considered before they are discharged and not after. It’s not only physical wounds of war that must be taken into account during the discharge classification process, but invisible wounds too, which can be long lasting and debilitating in their own right.
When we don’t acknowledge the invisible wounds of our nation’s heroes in the way we conduct our discharge system, we not only cheat them out of benefits, including healthcare, pensions and higher education, but also cheat them out of respect, validation and for many, seeking out the help they may need to lead them on a path of recovery. We may also cheat our nation out of quality active duty personnel who simply need and deserve more comprehensive treatment.
Though mental health is required for consideration during the discharge process, recent media accounts criticize the extent to which mental health considerations are actually weighed. Research indicating that post-combat mental health issues can be a significant factor in bad conduct that leads to discharge has underscored the importance of mental health within the discharge process.
Mental health issues that develop as a result of war, such as post-traumatic stress (PTS), depression, anxiety or a combination of these issues, culminate in a number of behaviors that can lead to destructive conduct if gone unchecked. According to the Anxiety and Depression Association of America, symptoms of PTS that are often precursors to or agents of reckless actions can include irritability, aggression and impaired rationality. As many are aware, mental health struggles may also lead individuals to self-medicate with drugs or alcohol which present their own additional set of behaviors and challenges.
Marine Chief Warrant Officer Cooper Williams has made headlines lately for his fight to stay in the Corps following a potential discharge related to several DUIs. Williams, who struggles with PTS and a traumatic brain injury after surviving an explosion, used alcohol as a means to cope with war-related PTS that emerged on top of his parents’ murder-suicide.
BMC Psychiatry conducted a five-year study of Marines that found those with PTS or other psychiatric conditions were more likely to have a drug-related discharge compared to service members who did not experience similar mental health setbacks.
Alcoholism and drug addiction obviously play a significant role in determining the quality of an individual's overall mental health and as such, should be taken into consideration as valid setbacks when members are evaluated for discharge. These types of diseases should not simply be considered untoward or irresponsible behaviors, but instead should be seen in the bigger picture of other mental health struggles, like PTS, and subsequently be met with treatment instead of discharge.
Though the addition of a mental health evaluation in the discharge process in 2014 is certainly a necessary and positive step toward reaching an accurate and appropriate conclusion concerning an individual’s discharge classification, it currently benefits veterans in their attempts to change their discharge status after they have left the service. Unfortunately, it does little for active duty members, like Williams, as they wade through the process of attempting to remain on active duty.
In light of this, mental health conditions, including alcohol and drug addiction, that emerge and sometimes go undiagnosed during an individual’s military service should be considered before they are discharged and not after. It’s not only physical wounds of war that must be taken into account during the discharge classification process, but invisible wounds too, which can be long lasting and debilitating in their own right.
When we don’t acknowledge the invisible wounds of our nation’s heroes in the way we conduct our discharge system, we not only cheat them out of benefits, including healthcare, pensions and higher education, but also cheat them out of respect, validation and for many, seeking out the help they may need to lead them on a path of recovery. We may also cheat our nation out of quality active duty personnel who simply need and deserve more comprehensive treatment.
Transition
PTSD
Mental Health
Discharge
PTS
Posted 4 y ago
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- We need better screening.
- We need to standardize how unit leaders treat those with mental problems.
- We need mental health therapists who understand PTSD better. We have regulations, SOPs, FMs but nothing like a standardized treatment plan for those who have PTSD.
- We need to educate the SMs better about the MEB process and the VA.
- We need to put the SMs in WTU/WTBs if they are available.
- We need to standardize how unit leaders treat those with mental problems.
- We need mental health therapists who understand PTSD better. We have regulations, SOPs, FMs but nothing like a standardized treatment plan for those who have PTSD.
- We need to educate the SMs better about the MEB process and the VA.
- We need to put the SMs in WTU/WTBs if they are available.
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MAJ Ken Landgren
CPO Cory Cook -
Good question.
If I had to write the SOP either someone with more rank told me I needed to write an SOP. If not, I would go to my superior with some good rank to tell the boss about the project and the support I would need from the boss as overhead cover to open doors to me.
I would lay on the couch and brainstorm the process in my head. I would build a flow chart to determine what all the entities are involved in mental health. I would ask all the entities to give me information. Perhaps like Tasks, Conditions, Standards. That is just one way to look at it. The point is to ask what do the entities do and how do they fit in the big picture.
I would then write a draft SOP. Upon completion I would send the draft SOP to the head of the various entities to staff the SOP and tell them if they concur, non-concur, and if they want to add more information.
I would rewrite the SOP and send it to the heads of the entities again. Hopefully at this point we have the 100% solution. Then it becomes an SOP, but it has to be a living document in case there are changes to the processes.
That my friend is how it should be done.
Good question.
If I had to write the SOP either someone with more rank told me I needed to write an SOP. If not, I would go to my superior with some good rank to tell the boss about the project and the support I would need from the boss as overhead cover to open doors to me.
I would lay on the couch and brainstorm the process in my head. I would build a flow chart to determine what all the entities are involved in mental health. I would ask all the entities to give me information. Perhaps like Tasks, Conditions, Standards. That is just one way to look at it. The point is to ask what do the entities do and how do they fit in the big picture.
I would then write a draft SOP. Upon completion I would send the draft SOP to the head of the various entities to staff the SOP and tell them if they concur, non-concur, and if they want to add more information.
I would rewrite the SOP and send it to the heads of the entities again. Hopefully at this point we have the 100% solution. Then it becomes an SOP, but it has to be a living document in case there are changes to the processes.
That my friend is how it should be done.
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CPO Cory Cook
MAJ Ken Landgren I wholeheartedly agree "living document"...it will never be complete.
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CPO Cory Cook
MAJ Ken Landgren I would not limit the criticism to the Army alone. Every branch is involved, not excluding the National Guard. Not sure complacency could be aptly applied either. My guess is a fear of casting stigma on members affected, and a fear of the American public that it is happening so widely...but, that is just a thought, not even an opinion. Not being an authority, I can only guess at what I've seen.
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The truth is you don't even know you have it most of the time until you leave service. Most take it just adjusting back into their civilian life as the obstacle not knowing they are in need of help. Also if you were like me ,going to sick call would trigger a negative reaction from your command and sort of put you on the radar. As i progressed in rank i adopted the same mind set that i incorporated in my style of leadership. Its like a never ending cycle and we are the ones to pay later if we try to file a claim and nothing is documented.
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CPO Nate S.
MSG Michael Hankins Unfortunately, logging MH issues, can be discriminating beyond other obvious forms.
I would argue, as someone who has had to respond to MH emergencies, in the wee hours of the morning in sickbay in the middle of the ocean that it is about properly managing the double edge blade of being a compassionate leader and maintaining good order and discipline, while at the same time letting a sailor / marine (officer or enlisted) you are listening. Not easy, to say the least!
There will always be those who want to be excused for deliberate bad behaviors using MH as a ruse because they don't want to be held accountable. But, their are many more who have no problem with being held accountable that don't want to be "punished" for having the integrity to ask for help and then act in proper manner to execute the plan they asked for help with. Yet, it is when MH is weaponized it is at its worst! I have seen MH weaponized and used by those whose behavior because of rank and status was not to be questioned, but was questionable. The destruction of trust and unit cohesion is devistating under such conditions. Thus, offering to subordinates, a "no way out" scenario, verse providing a relieve value, that still keeps the boiler intact but releaves pressure, before the boiler explodes harming so many more, that with a properly operational relieve valve.
While we need better tools, etc. we need leaders at all level to have a better understand and be able to offer help when there are "early warning signs", to keep some our best and brightest still shining vs dulling their luster in undue fear of being able to asked for help.
I spoke with my for boss the other day. Had he not seen my need and been preemptive in a positive way, I would not be here today giving you this response. I thank God that in that time of need he expected me do my duty, but know I had been throught a very traumatic experience and nudged me into help he and others knew I needed so I could move to fulfil a potential he knew I had.
We (I) call that - LEADERSHIP not management!!!
I would argue, as someone who has had to respond to MH emergencies, in the wee hours of the morning in sickbay in the middle of the ocean that it is about properly managing the double edge blade of being a compassionate leader and maintaining good order and discipline, while at the same time letting a sailor / marine (officer or enlisted) you are listening. Not easy, to say the least!
There will always be those who want to be excused for deliberate bad behaviors using MH as a ruse because they don't want to be held accountable. But, their are many more who have no problem with being held accountable that don't want to be "punished" for having the integrity to ask for help and then act in proper manner to execute the plan they asked for help with. Yet, it is when MH is weaponized it is at its worst! I have seen MH weaponized and used by those whose behavior because of rank and status was not to be questioned, but was questionable. The destruction of trust and unit cohesion is devistating under such conditions. Thus, offering to subordinates, a "no way out" scenario, verse providing a relieve value, that still keeps the boiler intact but releaves pressure, before the boiler explodes harming so many more, that with a properly operational relieve valve.
While we need better tools, etc. we need leaders at all level to have a better understand and be able to offer help when there are "early warning signs", to keep some our best and brightest still shining vs dulling their luster in undue fear of being able to asked for help.
I spoke with my for boss the other day. Had he not seen my need and been preemptive in a positive way, I would not be here today giving you this response. I thank God that in that time of need he expected me do my duty, but know I had been throught a very traumatic experience and nudged me into help he and others knew I needed so I could move to fulfil a potential he knew I had.
We (I) call that - LEADERSHIP not management!!!
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