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You Are Not Alone - Mental Health Care is Not One-Size-Fits-All

Soldier with head in hand. The DOD’s theme for National Suicide Prevention Month is “Connect to Protect: Support is Within Reach.” Deployments, COVID-19 restrictions, and the upcoming winter season are all stressors and potential causes for depression that could lead to suicidal ideations. Options are available to individuals who are having thoughts of suicide and those around them (Photo by Kirk Frady, Regional Health Command Europe).

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If you or someone you know is struggling with a mental health problem or suicidal thoughts, it’s important to know that there is not a one-size-fits-all solution, and finding the best option is key to a successful recovery.

For some people, just talking to a friend or family member can help. Others might prefer the privacy of seeking help online.

Talking to chaplains, primary care doctors or visiting a behavioral health clinic may be the best option for someone in crisis. There is also immediate help available for the most acute and urgent problems that may involve suicidal ideations.

“It depends on the severity. If you’re concerned about the immediate welfare of someone, I think the best thing to do in that case is to contact 911 or emergency services,” said U.S. Public Health Service Capt. Meghan Corso, chief of Behavioral Health Clinical Operations within Defense Health Agency’s Medical Affairs/Clinical Support Division at DHA headquarters in Falls Church, Virginia.

Aside from September being National Suicide Prevention Month, she noted that this is an especially important time to be aware of mental health issues given the “wide range of emotions” that service members and their family members may be experiencing surrounding the recent end to the War in Afghanistan.

“We recognize that one size might not fit all, and we want to be able to meet folks where they are in the gateway in to care,” said Corso. “There’s also a wide range of ideations, from mild to more severe, so again it really depends on that level of acuity and severity. We then match the level of care and intervention to that particular individual.”

The bottom line is that there are several options for getting help sooner rather than later.

A good option for many people is the integrated behavioral health consultants, typically psychologists or a social workers, who are assigned across the Military Health System at any primary care clinic with an adult enrollment of more than 3,000 beneficiaries.

They are there for same-day appointments – professionals to talk to right then, right there – in the event a beneficiary needs them.

“This means that they have immediate access, and this applies to anybody who is enrolled at that military medical treatment facility,” added Corso.

The military has gained momentum in recent years to reduce the stigma that was once associated with getting help, especially among service members.

“We have really worked hard to de-stigmatize help-seeking and what that does, is normalizes the experience and helps the desire to go in and get help, which is what we need people to do,” Corso said. “We need them to raise their hand or intervene with a colleague or friend that they’re concerned about.”

An additional barrier to getting help for some, she said seeking help rarely results in an adverse impact on a person’s job or potential revocation or denial of a security clearance.

According to data from the Defense Counterintelligence and Security Agency, the agency responsible for determining security clearance eligibility, “Denials and revocations for security clearances due only to psychological issues is a .00507% chance,” said Corso.

In short, it will likely not ruin your career.

“There’s a really small risk to security clearances for seeking mental health services, and we’ve tried to get that word out,” Corso said.

Currently, the Department of Defense routinely screens active-duty service members at military treatment facilities for depression, including annual person-to-person mental health assessments as part of their periodic health assessments.

“We do a lot of mental health screening around the deployment cycle, too,” Corso said. “They’re frequently scanning and screening folks, especially those who have deployed, for mental health treatment.”

One of the most effective ways to support a friend or family in crisis is by simply staying connected.

“If you’ve heard the sentiment, ‘It’s a permanent solution to a temporary problem,’ I think understanding and validating that people go through life events that are difficult is important. They need to know that there are people around them that really do care for them and want to help them with whatever it is that they’re facing,” said Corso. “I think when you pull together your family and friends – your support network – and professional medical providers, if needed, they can really help address what might feel like a very helpless situation.”

She added: “We really want to drive home the fact that being connected to other people is critical to life, let alone if you are going through a difficult time.”

Dr. Tim Hoyt, chief of Psychological Health Promotion and supervisor of the Combat and Operational Stress Control mission at DHA’s Psychological Health Center of Excellence, agreed that talking to friends and loved ones in crisis can be hard, but it can also be extremely important.

“Listen, and let your friend do most of the talking. When they open up, express interest and don't judge them – ‘I'm glad you're talking to me about this and I'm here to support you’,” said Hoyt.

If you are genuinely concerned that they may be thinking about hurting themselves, it’s best to be direct, Hoyt said.

“Ask ‘How are you coping with this?’,” Hoyt said. “Express genuine concern and ask the straightforward question: ‘I know you've been going through a lot lately. You're my friend and I care about what you're going through. I know it's common to experience depression or thoughts of suicide during times like these. Have you been thinking about killing yourself?’.”

It's important to know that asking a friend about suicide won't cause that friend to attempt suicide, he said.

Mental health resources for Military Health System beneficiaries include:

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