[Congressional Record Volume 159, Number 65 (Thursday, May 9, 2013)]
[Senate]
[Pages S3321-S3322]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                     MENTAL HEALTH AWARENESS MONTH

  Mr. CARDIN. Mr. President, May is Mental Health Awareness Month. The 
Mental Health America organization began this campaign in 1949 in an 
effort to raise awareness of mental health conditions and mental 
wellness. Even after more than 60 years, however, we are still fighting 
against the stigma of mental illness and for greater access to mental 
health services for all Americans.
  I would like to call particular attention to mental health issues 
affecting our Active-Duty service men and women, our veterans, and the 
impact of these issues on thousands of military families.
  The protracted military operations in Afghanistan and Iraq have made 
mental health disorders some of the ``signature'' wounds our military 
members experience upon returning from these conflicts. A comprehensive 
study by RAND found that approximately 18.5 percent of those returning 
from deployment reported symptoms consistent with a diagnosis of post-
traumatic stress disorder, PTSD, or depression. And up to 30 percent of 
troops returning home from combat develop serious mental health 
problems within 3 to 4 months. Unfortunately, due to the stigma 
associated with seeking help and the fear of risking their careers, our 
service men and women often do not seek the care they desperately need 
and are entitled to receive.
  In fact, according to a recent Department of Defense, DoD, report, 
mental health disorders are the leading cause of disability among U.S. 
military members. Recent studies illustrate that out of the 1.4 million 
Active-Duty servicemembers, mental health disorders are the leading 
cause of hospitalization among men and the second leading cause for 
women, only after pregnancy-related conditions.
  The five most common mental disorders our military members face are 
post-traumatic stress disorder, PTSD, major depression, bipolar 
disorder, alcohol dependence, and substance dependence. These disorders 
are likely to be chronic in nature or long-lasting in duration.
  Since mental health issues often aren't immediately addressed on 
Active Duty, we see even higher numbers of mental illness diagnoses 
among our veterans. According to the Department of Veteran Affairs, VA, 
the number of veterans receiving specialized mental health treatment 
from the VA has risen each year, from 927,052 in fiscal year 2006 to 
more than 1.3 million in fiscal year 2012.
  One major reason for this increase is the VA's proactive screening of 
all veterans to identify those who may have symptoms of depression, 
PTSD, or problem use of alcohol or drugs. As we anticipate a growing 
number of incoming veterans with this need for care, increasing 
availability of qualified mental health professionals is absolutely 
imperative.
  I commend VA Secretary Shinseki's recent decision to hire an 
additional 1,600 mental health staff at the VA. We know our veterans 
need these services and we must do everything we can to provide them 
with the care they need.
  The invisible wounds of war are not new--they were called ``shell 
shock'' or ``combat fatigue'' after World War I and World War II, or 
``post-Vietnam syndrome'' after Vietnam. But there are unique features 
stemming from our prolonged engagement in Iraq and Afghanistan.
  First, our troops have experienced more frequent deployments of 
longer duration while having shorter ``dwell time,'' creating a more 
stressful environment.
  Second, we have the highest rate of survivability in history for 
serious injuries such as amputations, severe burns, and spinal cord 
damage, leading to greater need for mental health care.
  Third, the prevalence of traumatic brain injury, TBI, from improvised 
explosive devices, IEDs, and other blasts have increased the number of 
combat veterans with mild to severe diagnoses, which are linked to 
other psychological comorbidities.
  It took the DoD and the VA too long, unfortunately, to realize that 
their medical care system must provide the same level of expertise, 
resources, and dedication to address the psychological wounds of war as 
they do for physical ones.
  Although the DoD and the VA have made progress in the past 5 years, 
there is still a great gap between the mental health needs of our 
military members and their access to quality care.

[[Page S3322]]

  This is an epidemic that needs to be resolved. Recent reports 
indicate that nearly 22 veterans commit suicide every day. In 2012, 
more than 349 Active-Duty service men and women across the four 
branches took their own lives. That is an average of 1 every 25 hours, 
the highest suicide rate ever in the DoD.
  It is not just about resources. In fact, having an adequate number of 
mental health professionals is just one component of ensuring access to 
care.
  Former Secretary of Defense Leon Panetta testified in a hearing the 
Senate Appropriations Subcommittee on Defense held last year that he 
was unsatisfied with the Pentagon's current approach to combating 
military suicides and admitted that the DoD needs to review its 
procedures for handling mental health cases. Secretary Panetta said 
that there are still huge gaps in the way a mental health diagnosis is 
determined. Furthermore, Secretary Panetta acknowledged that the 
greatest obstacle to service men and women receiving necessary mental 
health treatment is the stigma that continues to be associated with 
seeking help for psychological injuries.
  Throughout Maryland, I hear from service men and women who believe 
that seeking mental health services will hurt their military careers. 
We must overcome these real and perceived barriers to care by changing 
the policies that govern how we provide mental health care to our 
military members. Those who are hurting in silence will seek treatment 
only when they can truly speak freely and off the record. As more and 
more of these individuals go untreated, we will continue to see a rise 
in suicides and other tragic incidents among our military members and 
veterans.
  Even as we wind down our combat operations in Afghanistan over the 
next year, I fear that we will continue to see an increasing number of 
our military members and veterans needing mental health care in the 
near future.
  Yet the DoD now is facing looming furloughs and unnecessary funding 
cuts, which could force the DoD to lose many of the highly valued 
mental health and behavioral professionals who were hired to help treat 
soaring rates of PTSD. Recently, Dr. Jonathan Woodson, the Assistant 
Secretary of Defense for Health Affairs, stated his concerns over the 
DoD's long-term capability to provide mental health care to the force, 
to counter the effects of PTSD. More than one-half of the mental health 
specialists serving the military are civilians, and they have options 
to seek employment elsewhere. I worry about sustaining this valuable 
workforce under constant threat from sequesters.
  Mr. President, we need to ensure that we have the personnel, 
resources, and policies in place to guarantee access to quality mental 
health care for our men and women in uniform, our veterans, and their 
families. Active-Duty service men and women especially need access to 
such care without fear of being stigmatized of suffering career-
damaging consequences. Providing such care isn't just a good idea to 
maintain the well-being and readiness of our troops; it is our solemn 
moral obligation to those who have sacrificed so much for our great 
Nation. It is important for us to remember that--especially during 
Mental Health Awareness Month and as we approach Memorial Day.

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