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NEWS | Feb. 2, 2011

Chiarelli expects increase in behavioral health needs

By J.D. Leipold Army News Service

WASHINGTON - The Army's vice chief of staff said with the drawdown in Iraq and eventually in Afghanistan, the country could expect to see an increase in the number of Soldiers suffering from depression, anxiety, Traumatic Brain Injury and post-traumatic stress.

Speaking at the opening of the Reserve Officer Association's National Security Symposium Jan. 30, Gen. Peter W. Chiarelli praised the Reserve component for being "truly remarkable" in what he called a nearly decade-long era of "persistent engagement," and added that the health and well-being of U.S. forces was absolutely critical to the security of the nation.

"Soldiers and their families are under tremendous stress and strain, physically and emotionally," he said. "Unfortunately, and I've said this often over the last couple of years, I do think it's going to continue to get harder, at least for a little while longer before it gets easy."

Of particular concern to Chiarelli were the physically hidden or unseen wounds -- Traumatic Brain Injury and Post-Traumatic Stress, or PTS. Citing the Army Wounded Warrior Program population, he said as of Jan. 1, some 63 percent of the more than 9,000 Army Wounded Warrior Program Soldiers were diagnosed with behavioral health injuries -- 47 percent had PTS, 16 percent Traumatic Brain Injury.

He added that while the Army was taking a holistic approach to dealing with these injuries, "the reality is the brain is incredibly complex," he said. "Most efforts aimed at diagnosing and treating these conditions are in their infancy.

"We're working very, very hard with researchers, doctors and medical professionals around the world to develop new and improved protocols to better identify and diagnose injuries as well as treatment options that will further enhance and expand upon our ability to provide much-needed support to Soldiers and Families," he said.

Chiarelli said he was excited about Army Study to Assess Risk and Resilience in Servicemembers, or STARRS, a joint $50-million, five-year STARRS. When the study is complete in 2014, he expects the results will have unprecedented impact on PTS and Traumatic Brain Injury.

Addressing suicide, the general said the Army in 2010 had modest success in reducing the number of suicides by active-duty Soldiers, but the number of suicides by Reserve-component troops not on active duty had increased, and doubled in the non-active National Guard.

"We attribute the modest decrease in suicides by Soldiers serving on active duty last year to the programs and policy changes that have been implemented since the establishment of the Health Promotion Risk Reduction Task Force council in March of 2009," he said, citing the Comprehensive Soldier Fitness program.

"Our goal is to increase Soldiers' and individuals' resiliency to help them move away from the edge," Chiarelli said, pointing out that when stresses are piled one on top of the other, "they will eventually reach the brink.

"In addition to the Comprehensive Soldier Fitness program, we've established a Pain Management Task Force to appropriately manage the use of pain medications and adopt best practices Army-wide," he said, referring to a recent internal report on the overuse of pain-relieving narcotics by wounded warriors.

After a leveling off of active-duty suicides, suicide attempts and high-risk behaviors, the real issue and question becomes, he posed to the audience, how can the Army carry over the same to the Reserve component?

"The reality is we are able to more effectively influence Soldiers serving on active duty and can help mitigate the stresses affecting them," Chiarelli said. "Conversely, it's much more difficult to do so in cases of individuals not serving on active duty because they're often geographically removed from the support network provided by military installations."

He added that the active force doesn't have employment stresses unlike the Reserve component, whose NCOs and Soldiers are more vulnerable to the challenges of an adverse economy and a troubled labor market.

Chiarelli noted that the Army was working closely through employer partnerships in the private sector. "We recognize we must do everything we can to provide predictability and also as much stability as possible."

"They (Reserve component) lack the camaraderie of fellow Soldiers and the daily oversight and hands-on assistance from members of the chain of command experienced in serving on active duty, and in many cases these Soldiers have limited and reduced access to care and services."

Chiarelli said the Army had initiated broadened authorizations for health care providers and initiated face-to-face post-deployment behavioral health screening for all returning brigades in order to identify high-risk behaviors. He also said Reserve and Guard Soldiers would spend more time at demobilization stations undergoing risk assessments.



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