The Army is trying to teach all of its soldiers to recognize symptoms of brain injuries and post-traumatic stress disorder - and not be ashamed of seeking treatment for the signature injuries of the Iraq war.
And the Pentagon also said Tuesday it would increase the number of R&R days troops can take while serving in Iraq and Afghanistan.
Beginning Wednesday, service leaders will start a program to educate more than 1 million soldiers within 90 days, whether at home or deployed overseas, including active duty soldiers, the Army Reserve and the Army National Guard. The program also will be made available to families.
The key messages are that mild traumatic brain injuries, or concussions, and post-traumatic stress disorder are serious and soldiers should seek treatment, said Lt. Gen. James L. Campbell, director of the Army staff.
"They impact soldiers and they impact those soldiers' families," he told Pentagon reporters Tuesday. "And as a result of that, that impacts the readiness of our great army."
The program is designed to teach leaders and soldiers to recognize symptoms in themselves and others and to know what treatment is available, he said.
"I'm not naive ... there is a huge culture issue here," he said of a common fear that those who seek help for mental problems will be perceived as weak and that will damage their military careers.
The program will argue that the reverse is true - that getting help is a sign of personal courage, he said. "If young soldiers see other soldiers and their leaders seeking help, then what we do - and it's a slow process - is we reduce an associated stigma," Campbell said.
Trying to keep up
In small groups of about 40 people each, everyone is to receive a one-hour class on brain injuries and stress, in which teachers will be equipped with videos, slides and a list of expected questions and answers. It will be done through a rarely used "chain teach" program; that is, the subject is taught to leaders, who then teach it to soldiers, continuing the sessions down through the Army's chain of command.
The effort is one of many being made by the Army and the Department of Defense to try to keep up with the wounded and injured from an Iraq conflict that has gone on longer than expected - a rising number of patients that has overwhelmed the military health care system.
The Iraqi insurgents' use of roadside bombs is the top killer in Iraq and also responsible for many brain injuries ranging from mild concussions caused by exposure to blasts up to severe trauma from penetrating head injuries. In addition to physical brain injuries, troops also are suffering stress and other mental-health problems from exposure to bad combat experiences, and long and repeated tours of duty.
Officials say as much as 20 percent of troops are returning from Iraq and Afghanistan with stress symptoms or brain injury.
The Pentagon has been working for some time to end the stigma of seeking psychological counseling. Studies indicate that soldiers most in need of post-combat health care are the least likely to get it because they fear that others will have less confidence in them, that it will threaten career advancement and that it could result in loss of their security clearance and possibly removal from their unit.
Officials have said that although the problem of stigma is pervasive not only in the military, but in American society as a whole, the evidence in the military is overwhelming. Fifty-nine percent of soldiers and 48 percent of Marines said they thought they would be treated differently by leadership if they sought counseling, according to a survey among troops who had been deployed.
The new policy on rest and recuperation announced later Tuesday gives troops serving 15-month tours of duty in the wars an extra three days off to travel out of the war theater and get a break from the conflict. They will now get 18 days instead of 15.
The change, signed by David S.C. Chu, undersecretary of defense for personnel and readiness, went into effect Friday, the Defense Department said. It did not explain why the policy was not announced earlier.
The change was the result of the decision earlier this year to increase tours in the war zones to 15 months from 12, a department statement said.