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Capt. Charles Williams, an Army psychologist, believes the number of soldiers seeking care is climbing as the stigma associated with mental distress has lessened.
The Army's concerted effort of the last several years to encourage soldiers to get the help they need, he said, seems to be working. "We have seen more people come in to seek help, which is a good thing," Williams said. "I feel like soldiers are coming forward to say, ‘I need help,' and command has a lot to do with that, saying, ‘It's OK.'"
Williams, an intern at Tripler Army Medical Center in Hawaii, was taking a course with the Center for Deployment Psychology in Bethesda, Md. The program teaches psychologists, who are often new to the military, to apply their broad academic training to help troops and their families cope with the stress of combat and deployment.
Funded by the Defense Department and headquartered at the Uniformed Services University of the Health Sciences, the center is catering to a growing field of military behavioral health professionals.
The center's executive director, Dr. David Riggs, told attendees of the two-week course about the difficulties of taking home war-zone anxieties. For some veterans, he said, the local Wal-Mart can be as frightening as a market in Helmand province.
Traumatic memories, anxiety and irrational fear can be triggered by sights, sounds, smells and activities that are not inherently dangerous but remind the soldier of a traumatic event.
Wal-Mart equals crowds, and crowds equal unpredictability and danger, the thinking goes. Likewise, driving can trigger memories of roadside bombings, and hot weather is reminiscent of the war zone. And forget about Fourth of July fireworks displays.
"When they are driving, they have the same physiological reaction, because when they were driving over there, things were blowing up," Riggs said.
The anxiety and depression troops feel are like anyone else's, but service members are a unique community with unique needs related to the deployment cycle, Riggs said. A mental health professional who doesn't know an NCO from an LT may alienate his patients and could have trouble helping them.
"We're learning that folks in the military, or veterans who served, feel more comfortable talking to a professional who at least doesn't stumble over the realities of functioning within the military," Riggs said. "It helps for providers to know something about military culture — both the values of that culture, but (also) knowing rank structure and what it means to [have a permanent change-of-station move] and the acronyms they're going to toss around."
The center offers training at sites around the country, typically to military psychologists who are about halfway into their yearlong internships. Though the courses saw more senior personnel when they began about two years ago, attendees lately tend to be newer, with a desire to serve and often a family connection to the military, Riggs said.
Among the attendees in Bethesda were Capt. Rosalinda Reyes, a 35-year-old former second-grade teacher whose husband is a soldier, and Williams, 46. Williams was an enlisted soldier in the 1980s, served as a policeman for more than 20 years and rejoined in 2008 under a military scholarship.
Both interns at Tripler, they said they were becoming psychologists in uniform to give something back. Reyes saw a career field that was growing with the needs of returning soldiers, and Williams said he wanted to help people on a deeper level than he could as a cop.
"At one time, I had an opportunity to go to law school, but I think I can help more here," Williams said. "In military psychology there's never a dull moment. You can teach, practice, there's so many things you can do."
Typically, the soldiers and family members Reyes and Williams encounter are dealing with anxiety or depression. Reyes said she had a heavy caseload, seeing more than six patients each day, often for insomnia or stress related to combat or family issues.
One of the rewards of the job, they said, is seeing patients progress, even over a three-month rotation, whether it's in managing their anger or lessening combat-related anxiety.
"Of course it's rewarding when they leave and say, ‘Thank you, I feel better' or ‘I can function,'" Reyes said. "They're smiling again, and that's why I'm in this profession."