Checking the Mental Health Block

“Next,” said the voice from a tiny cubicle.

A sign facing the door labeled it “Office #5.” It was just one tiny office among six others, with only a thin partitions separating them. I walked in. Behind the desk sat a kind looking lady–imagine a standard issue government employee and you got it–who motioned me to sit in the chair next to her desk.

A few minutes before, I’d received my redeployment paperwork, a glorified checklist. Once I filled it out, it meant I was home, safe and sound. I handed it to the mental health worker.

If you’ve spent more than a minute in or working with the Army, then you know what “checking the block” means.

“How are we doing today?” she** **asked.

“Pretty good,” I replied. “You know how it is trying to get all these signatures and stuff.” She just smiled in response. I tried to project confidence. Projecting confidence means you aren’t crazy.

The Army lives and dies by checklists. Need to set up a range? Instead of sitting down to figure out all the inherent risks, just find a previous range “Composite Risk Management” form, and change the names and dates. You’ve checked the range safety block. Need to conduct a battalion-sized operation? We have a checklist for that. Need to deploy? We have a pre-deployment checklist. Need a physical? Fill out the online Periodic Health Assessment, a checklist. Need to invade a middle Eastern nation? I’m sure there was a box to check for that too.

I had just returned from my second deployment, my first to Iraq. I was at Fort Campbell, a post that has led the Army in suicides in the past (though they don’t advertise that at the front gate). I was sitting down with a mental health worker to discuss my recent deployment. Unfortunately for me, and thousands of other soldiers, I was just checking the mental health block.

As the Army struggles to explain why suicides are climbing, they ignore a fundamental problem–a culture of checking the block. And when the Army “checks the mental health block,” it eventually impacts the Veteran Affairs department. An Army that “checks the mental health block” effects our whole society.

The mental health professional read aloud the questions I had just filled out. I reanswered each question.

I glanced up at the cubicle walls separating us from the other offices. Anything I said could be heard by all my peers waiting in line twenty feet away. Was I having trouble sleeping? (No.) Did I see any fighting downrange? (No.) Was I having nightmares? (No.) Was I drinking too much? (Nope.) I answered every question as quickly as possible, like the dozens of other Soldiers with me**.** All I cared about was getting through this as quickly as possible without getting** **the (undeserved) stigma of PTSD.

Recruits check the mental health block and hide any previous mental issues as best they can. (Jared Loughner tried to join the Army. Initial reports labeled him a veteran. Follow up reports said the Army didn’t accept him because of mental issues. To be clear, he admitted to habitual drug use.) Deploying Soldiers check the mental health block before deployment to keep their pay check coming. Redeploying soldiers check the mental health block for a variety of reasons–to get back to drinking, to protect their careers, or to avoid more questions.

And the Soldiers who don’t check the mental health block face a much more dire future: getting thrown out without any support. Two years ago, Congress specifically directed the Army to stop discharging Soldiers for “pre-existing personality disorders” if the Soldiers really had PTSD. Instead, the Army has had a 165% increase in discharges for “adjustment disorders.” Both conditions, pre-existing “personality disorders” and “adjustment disorders,” deprive discharged service members of eligibility for medical care from the VA.

In all, it took me less than three minutes to complete. I got my stamp, and I moved on to my next station. Could I have said more? Absolutely, that’s why I write a blog on national security, foreign affairs and, most importantly, my personal experiences.

Do I need to talk about my deployment? Absolutely, but not so it will jeopardize my career. I believe that, despite the Army’s assurances, it would impact my career, so I check the mental health block and move on.

The entire 101st Airborne Division is redeploying to Fort Campbell from Afghanistan in the next year. The process just started. I predict Fort Campbell will have a rash of suicides, even though it opened a new mental health facility. Even a new facility with dozens of new counselors isn’t enough to overturn the culture of “checking the box.”

Army suicides, PTSD, adjustment disorders, and the rise in military divorces have risen because of checking the mental health box. Instead of getting the counseling they need–Soldiers should have to sit down with counselors for time measured in thirty minute intervals, not five–Soldiers will get a checklist with maybe a dozen questions on it. The Army needs to remove the stigma even further from PTSD. We need to change a culture, a culture that checks the block, even in the most important areas.

Captain Michael Cummings writes for On Violence, a blog on military and foreign affairs written by two brothers–one a soldier and the other a pacifist. He is an active duty military officer who deployed to Afghanistan with the 173rd Airborne Brigade and recently returned from a deployment to Iraq.

The views expressed in this blog are those of the author and do not reflect the official policy or position of the Department of the Army, Department of Defense or the United States government.

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