Army to Train Soldiers About Brain Injuries, Other Mental Health Concerns

By Josh White
Washington Post Staff Writer
Wednesday, July 18, 2007

The Army plans to begin a program today to educate every soldier about traumatic brain injury and post-traumatic stress disorder. The rare effort to break the perceived stigma within the military on mental health problems comes as increasingly more troops return from battle with serious but undiagnosed conditions.

Senior Army leaders are using a "chain-teaching" method to reach all U.S. soldiers, including more than 150,000 who are facing combat in Iraq and Afghanistan, within 90 days. Such a technique extends down the chain of command, with commanders educating their subordinates until individual soldiers are taught by their platoon leaders.

Lt. Gen. James L. Campbell, director of the Army staff, said yesterday that the impetus is a growing recognition that brain injuries and mental trauma are real problems that affect soldiers, their families and the general readiness of the Army. But many soldiers have been reluctant to seek help because of a perceived stigma, he said, and others have fallen through the system's cracks and have been overlooked.

"We want to try to educate our soldiers and our leaders . . . to be able to recognize the symptoms and then to be aware of the treatment options that are available," Campbell said. "There is a huge culture issue here, and it is this: that those leaders or soldiers who seek help could be perceived as being weak. And the whole thrust behind this program is that if you are in fact someone who needs help, that your desire to get that help is not perceived as a weakness but rather as a strength, as a personal courage to do it."

Much of the training centers on a 35-page guide that will be used to show videos and slide shows and to answer questions. The material covers how to notice symptoms of hard-to-detect mild brain injuries such as concussions, as well as the warning signs of post-traumatic stress disorder.

Army officials hope that the training will increase the number of reported cases of such problems as soldiers become more comfortable seeking help for nightmares, flashbacks and emotional withdrawal. That, however, will probably stretch Army resources; the service is already short about 270 mental health providers nationwide. There are about 200 mental health experts on the battlefield who help care for soldiers facing the daily threats of makeshift bombs, sniper fire and injury to comrades.

"A marker of our success is if we get an increased referral rate," said Col. Elspeth C. Ritchie, the top psychiatry consultant to the Army surgeon general. "It's going to be a strain, and we're working as hard as we can."

The training materials include video clips of roadside bomb explosions and dramatic re-creations of situations involving soldiers after they return from combat. The goal is to let soldiers know that apparently routine situations in the war can lead to mental health concerns later. Army officials said yesterday that the video and training materials were created in-house, at no additional cost to taxpayers.

The Army has also developed a separate video for soldiers' families and materials for young children, and officials plan to post all of the materials at The Army has created the "Wounded Soldier and Family Hotline," which can be reached at 800-984-8523 or by e-mail at

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