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WASHINGTON — Defense Secretary Robert Gates on Thursday urged troops to get psychiatric counseling for wartime mental health problems, saying it's "not going to count against them" if they apply for national security clearances for sensitive jobs.
Gates announced a new policy under which troops and civilian defense employees will no longer have to reveal previous mental health treatment unless it was court-ordered or involved violence.
He spoke to reporters after he visited with patients at a new center at Fort Bliss, Texas, designed to treat soldiers returning from war with post-traumatic stress disorder.
Gates pointedly called PTSD one of the "unseen wounds" of war. He said there are two issues in dealing with it, the first being developing care and treatment.
"The second, and in some ways perhaps equally challenging, is to remove the stigma that is associated with PTSD and to encourage soldiers, sailors, Marines and airmen who encounter these problems to seek help," he said.
Thousands of troops are coming home from Iraq and Afghanistan with war-related anxiety, depression and post-traumatic stress. But many hesitate to get psychiatric care because they fear that could cost them their security clearances, harm their careers and embarrass them before commanders and comrades.
A question on the government application for security clearances — what Gates called "the infamous Question 21" — has long asked federal employees whether they have consulted a mental health professional in the past seven years. If so, they are asked to list the names, addresses and dates they saw the doctor or therapist, unless it was for marriage or grief counseling and not related to violent behavior.
The new question allows them to answer "no" if the counseling was for any of the following reasons and was not court-ordered:
* Strictly marital, family or grief counseling not related to their own violent behavior;
* Strictly related to adjustments from service in a military combat environment.
Gates said a letter will be attached to applications explaining the department's position on therapy.
"Seeking professional care for these mental health issues should not be perceived to jeopardize an individual's security clearance," said the letter from James Clapper and David S.C. Chu, undersecretaries of defense for intelligence and personnel, respectively.
Rather, they said, "failure to seek care actually increases the likelihood that psychological distress could escalate to a more serious mental condition, which could preclude an individual from performing sensitive duties."
The newly written question also says getting counseling "in and of itself is not a reason to revoke or deny a clearance."
The Pentagon says the perception of stigma for security applicants is far worse than the reality.
The most recently released data show less than 1 percent of some 800,000 people investigated for clearances in 2006 were rejected on the sole issue of their mental health profiles.
Up to 20 percent of the more than 1.6 million troops who have served in Iraq and Afghanistan are estimated to have mental health problems, the Defense Department says.
Successive government and private studies have found roughly half of those who need help are seeking it.
Revising the security clearance procedure is the latest in a string of efforts aimed at changing military attitudes on mental health:
* The Army last year held special sessions to teach 800,000 troops how to recognize concussions and mental problems in themselves and their buddies.
* The Army and Navy have put mental health professionals into primary care centers — rather than separate locations — so troops can go for appointments discreetly.
Advocates of better mental health care for troops said the new policy could be a small but important step.
"This needs to be followed by a mental health campaign — not just for service members but for their families, as well," said Paul Riechoff, executive director of Iraq and Afghanistan Veterans of America. "But I really do think it's a significant evolution."
A survey released Wednesday by the American Psychiatric Association found that about three in five service members think seeking help for mental health concerns would have at least some impact on their careers.
"The military has made strides in raising awareness of mental health, but it's going to take a tremendous commitment to overcome attitudes that are ingrained in the military culture," said association president Carolyn B. Robinowitz.
ON THE WEB:
http://www.opm.gov/forms/pdf_fill/sf86.pdf">National Security Questionnaire
http://tinyurl.com/38zfmq">Army battlefront survey