"War is difficult. It takes a toll,"
Today I am talking about the troops, Post-Traumatic Stress Disorder and something called a Licensed Professional Counselor - I'm one of those.
LPC's, as we are called in Georgia, are people who have completed specific educational requirements and have jumped through a variety of hoops to ensure competency in the field of counseling and psychotherapy. There are a couple bills in the works now that will make LPC's much more available to US troops who need specialized mental health care.
Mental care stays are up in military is a poorly titled but important article in USA Today last week.
Last year was the first in which hospitalizations for mental disorders outpaced those for injuries or pregnancies in the 15 years of tracking by the Pentagon's Medical Surveillance Monthly report.
Hospitalizations for mental disorders have increased significantly among troops since 2005, said Lt. Gen. Eric Schoomaker, surgeon general for the Army. "War is difficult. It takes a toll," he said.
Mental health treatment expenses are helping drive up the overall cost of military health care, USA TODAY reported last month. Last week, Defense Secretary Robert Gates said in a speech that "health care costs are eating the Defense Department alive." Schoomaker said the Army's increased attention to mental health issues is another reason for the rise in hospital admittances.
As the military suicide rate has increased the DOD has, rightfully, begun (finally) to pay increased attention to the issue. Military suicides have exceeded 20% of the overall US suicide rate (over 20% of all suicides are US troops) as wars in Iraq and Afghanistan (where the 1000th soldier has been killed) drag into the 9th year.
So the DOD has tried to do something about it. I suppose most of us can rally behind such an effort.
Enter Joe Leiberman
Senators Joseph Lieberman (I-CT), Claire McCaskill (D-MO) and Susan Collins (R-ME) jointly introduced S. 3371 to allow licensed professional counselors to independently treat and diagnose TRICARE beneficiaries. The American Mental Health Counselors Association, the American Counseling Association and the National Board for Certified Counselors applaud the senators for sponsoring this legislation, as it is a much-needed step forward in giving TRICARE beneficiaries better access to highly skilled outpatient mental health professionals. Our three organizations are working closely together to gain the enactment of legislative language providing counselors independent practice rights as part of this years National Defense Authorization Act (NDAA).
Basically what this does is make available a rather large number of highly qualified people to begin providing proper counseling and psychotherapy to our troops who will be returning from these long wars in greater and greater numbers.
Introduction of S. 3371 comes on the heels of a recently released Institute of Medicine (IOM) report that recommends independent practice of mental health counselors in TRICARE. The Institute of Medicines report, titled Provision of Mental Health Counseling Services under TRICARE, was conducted pursuant to a request by Congress contained in the National Defense Authorization Act for Fiscal Year 2008.
The IOM panel recommended granting independent practice authority for counselors who have:
- A masters (or higher) degree in mental health counseling from a program accredited by the Council for Accreditation of Counseling and Related Education Programs (CACREP);
- Obtained state licensure in mental health counseling at the clinical or highest level available;
- Passed the National Clinical Mental Health Counselor Examination (NCMHCE); and
- Have a well-defined scope of practice sufficient to permit a counselor to see TRICARE beneficiaries absent primary care physician supervision and referral.
Representatives Tom Rooney (R-FL) and Mike McMahon (D-NY) introduced a similar bill, H.R. 3839, last October. The Rooney-McMahon legislation would let any counselor participating in the TRICARE program practice independently, just like clinical social workers and marriage and family therapists have done for years.
The legislation is currently being cosponsored by Reps. Bordallo (GU), Courtney (CT), Israel (NY), Jones (NC), Kilpatrick (MI), McMorris Rodgers (WA), Rodriguez (TX) and Shuster (PA).
Counseling can be considered the act of reviewing what is going on with a person while they are able to talk about and review issues of concern to them and discuss ways to address them; psychotherapy is where we employ a variety of exercises and techniques to get at deep-rooted feelings and issues, PTSD being one of the most well-known situations.
The traumas of war are special issues. War is a deliberate act by people where as a flood or an earthquake is just as devastating and indiscriminate in it's killing, the absence of the "people did this on purpose" angle isn't there. It's not something many people will "simply get over". Without proper help, people repress the memories risking a significant chance the trauma and related feelings will come out in other ways that are not controlled.
This legislation from Lieberman et al as well as the directive from the DOD also sends a message I want people to grasp: medications alone WILL NOT FIX THESE PROBLEMS.These folks cannot be handed a prescription and an appointment card for a month and be expected to "get over" the experiences they have had.
Psychotherapy and related human contact is essential in addressing PTSD symptoms, triggers, and traumas, allowing people to process them and "work through' issues that have arisen out of one's personal reaction to ugly traumatic experiences.
I am very pleased to see laws being made which support this sort of treatment being made much easier to get for our troops.