Is This What We Really Want For Our Soldiers And Their Families?

The Sounds of Silence #3
Mental Health Care
by Sheri de Grom

A potentially harmful contract has been let for bid to health service organizations by the U.S. Government on behalf of the Department of Defense (DoD). Health care organizations are attempting to assume the contract from the present contract holder for the Military and Family Life Counseling Program.

Magellan Behavioral Health, Inc., has been the clearing house for Tri Care’s mental health component for a number of years. Often they have been adequate in performing their duties and other times, impossible for active duty military, retirees and family members to understand and resolve differences. More often than not, mental health providers have refused to accept Tri Care because they are burdensome in the amount of paperwork required and take even longer to pay once services have been approved and provided.

Unfortunately, multiple deployments over the past ten years have left not only active duty military members with unresolved problems, but spouses and children who are baffled by what happened to the loved one they used to know.

The request presented by Magellan to prospective mental health employees, should they be awarded the contract, is three-fold:

1) a 6 month rotation in the United States

2) a 6 month rotation overseas

3) on demand services

A major concern of mine is that a mental health practitioner with real life experience in treating complex mental problems will already have in existence a full-time practice and ethics that will not allow them to leave their practice for six-month rotation periods. They will have office space rented and they cannot abandon their existing patients. Further, some of the patients may already be Tri Care patients. Tri Care pays more for a 50 minute appointment than they would earn under the proposed contract of $40/hour with no benefits (for a six-month contract that might roll over into another six months).

The proposal by Magellan reads, “You will make yourself available to accept assignments to locations within the United Sates and/or outside the United States designated by Magellan, which will involve full-time designation of your time for a rotation of one to six months or a short-term on demand or military surge assignment of one to thirty days, to provide the following services:

a) Face-to-face assessment, short-term counseling addressing the stressors of military life and other problems in living, and referral for treatment (“non-medical counseling services”) to military personnel and their family members (“clients”) at locations at military installations and/or communities in which military families live. You will use a walk around/just-in-time approach to deliver non-medical counseling services in addition to making appointments available as requested. The duration of counseling sessions may range from several minutes to two hours, depending on the circumstances.

b) This section pertains to services under the Child and Youth Behavioral program. It is straight-forward in its discussion.

c) Presentations to military personnel appear to be of routine matter.

The remainder of the proposed contract is what one might expect in any medical proposal.

This proposal might be an exciting opportunity for a young, inexperienced therapist who’s a recent graduate. It’s an opportunity to travel and have an immediate peer group to associate with. Additionally, the new graduate would incur no cost of doing business expenses.

A therapist in an unhappy practice, but one that’s already on the Tri Care approved list could easily drop into this contract. The therapist wouldn’t have to find a new practice to work within or set up a private practice.

Today, more than ever, our men and women in uniform need competent and experienced health care. In my opinion, we’ve never had such mental and emotional fragility among our armed services. Vietnam provided a mental health crisis but our country as a whole turned its back. We cannot afford to make that mistake again.

Our active duty military faces a high addiction rate to prescription pain medication, suicides are out of control, divorce rates have escalated and child abuse cases are heartbreaking.

We continue pretending that it’s okay to seek help for lives out-of-control due to multiple deployments but seeking help from a mental health care provider can still end a promising career in today’s armed forces. Nothing much has changed—those that can afford out-of-pocket expenses discreetly seek help in the private sector.

The current proposed contract doesn’t qualify for a band-aid fix and certainly doesn’t come close to adequate mental health care. The Veterans Affairs Administration cannot meet the demands of returning veterans and our active duty service members have no place to turn.

The Sounds of Silence will continue the debate of diminishing health care afforded both active duty and retired military along with the announced drawdown, hazardous materials clean-up attempts on closed bases, and other subjects of interest to the military/defense community.

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About Sheri de Grom

Retired Fed/JAG, 5 yrs. on Capitol Hill. Former book buyer for B and N. Concerned citizen of military drawdown. Currently involved in mental healthcare reform, health care strategist and actively pursuing legislative change wherein dual retirees are exempt from enrolling in Medicare at their own discretion without losing tertiary healthcare benefits. Monitor and comment on Federal Register proposed legislation involving Mental Health, Veterans Affairs, Health and Human Services, Medicare and rural libraries. Licensed OSHA Inspector to include Super Fund sites. Full time caregive to Vietnam era veteran. Conceptualized, investigated possible alternatives, authored, lobbied for, and successfully implemented Title X, Section 1095 (known as the Third Party Collection Program of Federal Insurance).
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8 Responses to Is This What We Really Want For Our Soldiers And Their Families?

  1. cindy knoke says:

    So important. Thank you for this post!

  2. Florence – The contract DoD let has more fatal flaws than I want to think about. It’s a sham to think it offers an ounce of hope to our men and women in uniform and certainly – it won’t lift a cloud for families waiting at home or family members wondering what happened to the one they loved before multiple deployments. Ten years and counting of war will take more than a few minutes of counseling/therapy here and there. Some will never be the same again. I see more novels on the shelves wherein the current wars play a central part – my hope is that I’ll be able to shed a little light into some dark corners about the reality of what we’re facing. Mental health continues to carry stigma for a career soldier – although the commands tell us otherwise. Career soldiers themselves will fake tests to return to the war zone – the military is their job. Finding a job when they leave the military is next to impossible. Our soldiers are in a tough position.

  3. Sheri, since you mentioned Viet Nam, my era … I feel it’s important to weigh in on this. The only thing the military complex in the US, its administrators, The Joint Cheifs and every congress since the end of the “happy” war and the war that was only a “police action” … to the one that never was officially declared is one thing … spend the dollars to make the war … and gripe endlessly about the cost of paying for its impact on those who we put in harm’s way. Personally, it makes me angry all over again. I wish I could believe that making the unconscous public “aware” might make a difference, but time has taught me that it will not. Thanks for caring.

  4. This is a very sad tale, Sheri. Another one of the many instances of the government taking advantage of the amazing services of the men and women who fight for the United States and people of other countries, but then afterward they are ignored or not taken care of properly. It is unfair and unbelievably cruel and many other adjectives that I won’t include in this comment. Thank you for bringing this to our attention.

    • Thanks for stopping by Patti. Wouldn’t it be nice if we could wave our flag and make the past ten plus years of war go away. We could bring back our loved ones lost and not worry about sending additional men and women off to foreign countries that don’t really want us. [Oh dear – I’m starting to sound a little opininated here]. I appreciate your taking the time to read about what’s happening to our Armed Forces. My heart aches. I think we share similiar adjectives.

  5. booklaurie says:

    I can see how somebody might’ve drafted such a proposal without really thinking it through, because at first glance it sounds pretty reasonable…but going through it point by point, the way you did, the whole thing looks awful!

    Not sure how good the current system is, but it seems like anything would be better than this new one.

    • Laurie – The waiting list for a mental health appointment is often over a year or more. Often clients are told to check back next week and then again, next week and the same answer is given over and over until the client gives up and never calls again. We know the outcome. The client associated with the military wherein mental health carries such a stigma, the individual is normally in crisis when they reach out the first time. Now that we’ve been at war ten years and counting, our mental health issues are more complex than ever – both in theater and at home. A psychiatrist once told me that the ‘Same Day Crisis Clinic’ might as well be called the ‘Same Year Crisis Clinic’ for all the good it did to call for an appointment or walk in. Mental health for the military has always been seriously flawed and it’s getting worse by the day. It’s not pretty. In all fairness, I must add, the mental health workers that devote their lives to our soldiers and their familes are just as frustrated with ‘the system’ as the remainder of the population. Thank you for checking in on this all-important issue.

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