Especially for soldiers who have endured multiple combat tours, the circle of trusted confidants becomes a select group. The director of special projects at the Tennessee Division of Alcohol and Drug Abuse Services uses a striking comment from a sergeant who lost both legs from service in Iraq to describe the soldier’s mindset.
Maggie Throckmorton recalls the veteran telling a group of behavioral health professionals, “There are three people I talk to: my God, my wife, and my battle buddy. If you want to be the fourth, you’ve got to let me know I can trust you.”
Deciding that a typical passive training session about military culture wouldn’t be sufficient to develop a more responsive clinical professional, the Tennessee agency teamed up with Department Veterans Affairs (VA) and National Guard leaders two years ago to expose treating professionals more directly to the military culture. OPERATION IMMERSION held two training sessions in 2009 in which Tennessee clinicians lived in barracks, engaged in pre-dawn Physical Training (PT) and heard from presenters with firsthand knowledge of military service and its effects.
This month, thanks to financial support from the Substance Abuse and Mental Health Services Administration (SAMHSA), the state will be able to host Access to Recovery (ATR) grantees from 19 states and five tribal organizations at the third OPERATION IMMERSION training. The event will be held in Smyrna, home of the Tennessee National Guard Training Center, from Aug. 30-Sept. 1.
“We knew that we had a workforce of behavioral health professionals that did not understand the uniqueness of military culture,” says Throckmorton, whose state agency is part of the Tennessee Department of Mental Health and Developmental Disabilities. “We surveyed our network of providers about what they knew about traumatic brain injury, post-traumatic stress disorder, and deployment, and they did not know a lot.”
News event hits home
On the first day of its second OPERATION IMMERSION training last fall, the group received a stark reminder of why it had convened. On that day, news broke of the mass shootings at Fort Hood in Texas. “It underscored the importance of why we needed to do this,” Throckmorton says.
Counselors and case managers from treatment organizations are the typical attendees at these trainings. The participants awaken at 5 a.m. for PT, they reside in barracks, and their food consists of Meal Ready to Eat (MRE) fare. The name tags they wear during their stay list their last name only.
“We don’t let the staff sergeants scream at people,” Throckmorton says, but the military setting and the presentations they hear from soldiers give the clinicians a unique opportunity to relate to military culture.
Throckmorton advises professionals who want to reach out to returning veterans in their community to contact their National Guard office, and to make an attempt to learn the military lingo. Most importantly, she warns about working with this population, “Do what you say you’re going to do.”
The more often these individuals are sent into service—a common occurrence with today’s citizen-soldier—the more insular their world will become, and the more challenging it will be for a treating professional to play a meaningful role.
While initiatives such as OPERATION IMMERSION demonstrate greater attention to soldiers’ behavioral health needs among military leaders, there remains a long way to go. For example, a Defense Department task force reported this week that despite having initiated hundreds of suicide prevention programs at military installations, the federal agency still has several holes in its approach. Problems include a shortage of behavioral health specialists and lingering discrimination against soldiers who seek help.