Question 21 of the security clearance application asks if the respondent underwent professional treatment in the past seven years for psychological or emotional problems. Servicemembers who seek treatment for problems related to deployment no longer need to check ěyes.î This change widens the waiver that previously covered behavioral health treatments formarital, grief or family-related stress.

Many people saw mental health treatment as a career impediment, because failure to gain needed clearances as a result of answering yes to question 21 would disqualify them from important posts. ěGood people, many of whom have seen combat up close and faced its grim reality, whose courage is absolutely unquestionable and who deserve only the best physical and mental health care we can provide, are actually willing to deny themselves that care out of fear that doing so hurts them and their Families in the long run,î said Adm. Mike Mullen, chairman of the Joint Chiefs of Staff at a press briefing May 1. ěNothing could be further from the truth, and itís time we got over that.î

Col. Patricia Horoho, Walter Reed Health Care System commander, told the Defense Department press corps, leaders must ensure their Soldiers know that psychological health is as important as physical health. ěJust as we encourage our service members to work out and maintain physical fitness, so we too must encourage them to go to the psychological gym to maintain their psychological health.î

Col. John Bradley, Walter Reedís chief of psychiatry, manages DoDís largest inpatient psychiatric program, as well as a robust outpatient practice. The problem, he said, is not with patients who are currently receiving care, but those who are avoiding it. ěThe DoD realizes that war is bad for your health,î he said. ěItís bad for your emotional health, itís bad for your physical health. What we want to do with affording treatment for those deployment-related concerns, is to mitigate the risk of long-term problems as a result of the Soldierís deployment to combat.î

A sight, a sound, a smell ó any of the senses can bring combat stress racing back to a service member, even several months after their return from combat, Horoho said. Leaders on all levels must ask the right questions and look for warning signs of psychological or emotional difficulties in Soldiers after deployment.

The large number of combat casualties seen by WRAMC health care providers since Sept. 11, 2001, adds additional stress for caregivers who have often deployed themselves. ěNot only do they deal with the deployment-related issues that our other servicemembers deal with, but then they come back and take care of the same kinds of combat wounds that they were taking care of on the battlefield, then [add] taking care of Family members,î Horoho said.

ěThey have the added stressors of trying to be supportive while at the same time trying to heal themselves,î she said.

WRAMC offers a full complement of mental and behavioral health services. Warriors in Transition have social workers and psychiatric nurses assigned to the Warrior Transition Brigade. Child and adolescent psychology services are available to help children deal with the reunion process.

For staff members, marriage and Family life counselors are available, as well as stress management programs, yoga classes and even acupuncture programs are available. ěSometimes you may need just one of them, sometimes you might need all of them put together to help with different stressors you have in your life,î Horoho said.

Bradley said Soldiers should check their own psychological well-being by ětaking their own pulse.î He said Soldiers in combat situations expect to get ěramped upî or on edge during combat. ěThose are exactly the sorts of things that keep them alive in combat. But when they come home they expect to settle back down to their normal baseline.î If they cannot return to normal, if they suffer from nightmares or re-experience combat situtations, Brad-ley said itís time to get help.

ěTreatment for combat-related problems is effective, itís available, and I really recommend that Soldiers who are in distress, after checking their own pulse and feeling theyíre not making the transition well back from combat, to come in and see your local mental health resources,î Bradley said. ěGet the treatment you need so your future is not affected with the complications of untreated illness.î

Find out more about combat and deployment-related mental health issues online at Battlemind.org, or Healthyminds.org.