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Military Stressing Veterans' Counseling

By Ann Scott Tyson
Washington Post Staff Writer
Friday, May 2, 2008

Applicants for government security clearances will no longer have to declare whether they sought mental health counseling after serving in combat zones, Defense Secretary Robert M. Gates announced yesterday.

The policy change is part of a broader Pentagon effort to reduce the stigma that military service members and civilian defense workers face in seeking care for post-traumatic stress disorder and other psychological wounds of war.

Gates said the security question -- which he referred to as the "infamous Question 21" -- has been an obstacle to care, and he urged service members to get help for mental health problems. "You can be tough and seek help for dealing with these problems," he told reporters.

The change will apply not only to military and civilian employees of the Defense Department but also to all applicants for security clearances.

The new policy revises the 21st question on the SF-86 Questionnaire for National Security Positions. The revised form allows applicants to respond "no" as to whether they have sought mental health care over the past seven years, if that care was not court-ordered and was "strictly related to adjustments from service in a military combat environment."

Previously, military personnel and others applying for the clearance who had sought treatment for PTSD, anxiety, depression and other reactions to combat stress had to answer "yes" and provide details of who conducted the treatment.

About 2.5 million of the 3.1 million defense personnel have security clearances. Only a small percentage of applicants were denied clearances for mental health problems, military officials said. They cited data for 2006 showing that only about 75 out of 800,000 applications were rejected for that reason.

Last year, a report by the Army's inspector general found that soldiers were hesitant to seek treatment because they worried about losing their security clearances. "The perception was much more an issue than the reality of the situation," said Lt. Col. Patrick Ryder, a Pentagon spokesman.

About 20 percent -- or 300,000 -- of service members returning from Iraq or Afghanistan report symptoms of PTSD or major depression, but only slightly more than half have sought treatment, a Rand Corp. study said last month.

This survey and others have shown that a major reason service members do not get help is the fear it will harm their careers. The Rand survey found similar concerns about reporting mental health treatment on deployment and fitness evaluations, or simply reluctance in telling commanders about mental health appointments. Revising the security form is a step toward reducing stigmas but more are needed, Rand researcher Terri Tanielian said.

"Seeking professional care for these mental health issues should not be perceived to jeopardize an individual's security clearance," said a memo signed by James R. Clapper Jr., the undersecretary for intelligence, and David S.C. Chu, the undersecretary for personnel and readiness, and released by the Pentagon yesterday.

"On the contrary, failure to seek care actually increases the likelihood that psychological stress could escalate to a more serious mental condition, which could preclude an individual from performing sensitive duties," the memo said.

At a Pentagon news conference, Adm. Michael G. Mullen, chairman of the Joint Chiefs of Staff, urged military leaders to set an example. "It's time for leaders of all stripes to step forward. . . . You can't expect a private or a specialist to be willing to seek counseling when his or her captain or colonel or general won't do it," he said. After nearly seven years of war in Afghanistan and more than five in Iraq, it's past time "that we recognize the toll it's taking inside our minds, as well as outside our bodies, and to deal with that reality," he said.

A Pentagon official at the news conference said the department expects that senior military leaders will come forward with their stories of receiving mental health care as part of a national campaign by the military to encourage service members to seek treatment.

"We can change the policy, we can talk about how important it is. Ultimately, troops and families, they want to see leaders walking that talk," said Col. Loree Sutton, an aide to the assistant secretary of defense for health affairs.

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