December 22, 2009, Washington, DC (Give an Hour) - As our nation engages in holiday celebrations and prepares to ring in the New Year, our military community prepares for additional troop deployments.

Following President Obama’s address to the nation on December 1, I received numerous inquiries from journalists regarding the impact of the president’s decision to send additional troops into Afghanistan on the mental health of our military community. Articles and reports in recent weeks have covered a range of topics associated with the mental health issues affecting those who serve. In addition, the shootings at Fort Hood and its aftermath continue to painfully draw attention to the need for more effective means to monitor the mental health of our fighting force as well as the mental health of those who care for them.

In early November the Army released a study indicating a decline in troop morale among those serving in Afghanistan. Also in November we learned that the number of suicides among Army personnel in 2009 will top last year’s record-breaking total. Meanwhile, a study by the Department of Veterans Affairs (published in the American Journal of Public Health in December) reports a three-fold increase in depression and post-traumatic stress after repeat combat duty. According to the results of the study, analyzed in the Christian Science Monitor, emotional pain, depression, and angst among U.S. soldiers experiencing multiple deployments in war zones seem much more common than the Pentagon has previously reported. Furthermore, soldiers facing multiple deployments are at least three times more likely to anonymously report problems of depression and post-traumatic stress disorder than are those with a single deployment.

We are also learning more about how soldiers and marines are responding to the increased emotional toll on our fighting force. USA Today recently reported the findings from a Pentagon health survey showing that about one in four soldiers admit abusing prescription drugs, most of them pain relievers, during the one-year period assessed. The study, which surveyed more than 28,500 U.S. troops, showed that about 20 percent of Marines had also abused prescription drugs, mostly painkillers, in that same period. About 15 percent of soldiers said they had abused prescription drugs in the 30 days before they were questioned for the survey. About 10 percent of Marines said the same thing. According to the article, painkiller abuse among troops has soared since 2005, the last time a similar study was conducted. The 2005 survey showed that 4 percent of soldiers had abused painkillers in the previous 30 days, compared with 13 percent in 2008. Abuse within the previous year was 10 percent in 2005 compared with 22 percent in 2008.

Finally, we are hearing more about the military’s ability to respond to the growing need and demand for mental health care. The New York Times reported on this topic in early December.  According to the article by James Dao and Dan Frosch, many soldiers, lawyers, and mental health professionals say that the rules governing confidentiality of therapist-patient relations in the military are porous and confusing and hinder treatment. The problem with the military rules, according to experts interviewed for the article, is that they do not safeguard the confidentiality of mental health communications and records as strongly as federal rules of evidence do for civilians. Civilian mental health professionals are required by law to report patients to the authorities when patients appear to be a threat to themselves or others but the military rules include additional exceptions that could be applied to a wide range of suspected infractions. As a result, many military personnel are reluctant to seek care from military providers for fear that their careers will be damaged in the process.

The decision to send troops into harm’s way must always be made with the utmost care—weighing national security needs against the readiness of our fighting force. In this case, the “readiness” of our force is an extremely complicated issue, based less on numbers of service personnel available and more on their ability to function effectively despite multiple deployments. Of course the news that more troops are being sent into Afghanistan has an impact on all of those who serve—all military personnel, their families, and those who are charged with their care. But how the news affects these men, women, and families depends on a number of factors.

For those military personnel and families who are exhausted by repeated deployments, the news may be difficult to absorb as it signals more demand on an already depleted force. However, what most Americans fail to understand is that the men, women, and families who serve are fiercely devoted to our country and to their mission. In addition, they are deeply honored to serve. Although many are exhausted and psychologically battered, there is no doubt that the majority of our military community will “suck it up” and carry on.

For some service members, the news about Afghanistan may be a relief in that it serves to clarify their mission. People generally handle stress more successfully when they are invested in the path they are on, when they believe that their actions have meaning, and when they believe they have the support of their larger community. President Obama laid out a clear rationale for sending additional troops into Afghanistan, a rationale that includes both short- and long-term goals for our fighting force. By presenting a strong case to the men and women who shoulder the responsibility for this war, Mr. Obama provided a psychological tool that may serve to assist those in harm’s way. The clarification of purpose won’t prevent the development of post-traumatic stress or other mental health issues, but it may reassure our soldiers and marines as they contemplate their participation in this war.

For those charged with providing care to the men and women who fight these wars—medical and mental health professionals in the Department of Defense and the Department of Veterans Affairs—the news of additional troops being deployed may lead to significant stress. These professionals are keenly aware that just as our fighting force is spread thin, so too are the resources to care for them as they come home. Fortunately, those in positions of leadership and power at both the VA and DoD appear to recognize that the only way to successfully care for our military community is to collaborate with community-based organizations that are capable of augmenting available governmental resources. I was recently asked by a reporter from the Austin American Statesman to project five years into the future, to predict whether we will be able to effectively care for our military community. If DoD and the VA continue to move toward increased collaboration with community-based organizations, I am optimistic that we will be able to care appropriately for the deserving men, women, and families who serve our nation. If this is not the path chosen, I have great concern for this generation of returning warriors and their families.

Regardless of our personal reaction to the president’s decision to send more troops into Afghanistan, 30,000 service members will respond to his call to action. Our country’s debate about this decision, while understandable, does nothing to assist the men, women, and families who must now prepare for deployment. As Americans, we have an opportunity to support those who serve. There is clearly a critical need for us to do so. If we step up to give our time, our expertise, and our support, we can ensure that these men and women will come home to a country that understands their needs and is ready to respond. As we prepare to ring in 2010, perhaps we can each resolve to join with those who serve—to educate ourselves about the issues affecting them and to do what we each of us can to care for them when they return.