The Infamous Question 21

Encouraging soldiers to take care of their health

IT'S JUST a change in wording on a government form. But the revision of the security clearance question on mental health is a welcome sign that the military is serious about changing how those in need of mental care are perceived and treated. It comes none too soon for service members returning from Iraq and Afghanistan with invisible wounds.

The Defense Department announced last week that applicants for government security clearances will no longer have to report mental health treatment for injuries related to combat. Details concerning treatment for grief or marital or family issues already were exempted from disclosure as long as the treatment was not court-ordered or resulting from violence. Defense officials said that in truth very few people are denied clearances for mental health issues, but the perception of a risk to careers remained.

A report by the Army inspector general last year documented that soldiers are reluctant to seek treatment because they fear losing security clearances. A study unveiled by Rand Corp. last month spelled out the consequences in startling numbers: Nearly 20 percent of those returning from Iraq and Afghanistan -- 300,000 in all -- reported symptoms of post-traumatic stress disorder or depression, but only slightly more than half sought treatment. The results of depression and PTSD going untreated are too often marital problems, drug use, unemployment and even suicide.

What Defense Secretary Robert M. Gates called the "infamous Question 21" is but one barrier to treatment. Problems persist with the system's capacity to provide effective treatment. Service members surveyed in the Rand report worried that they would be viewed as less capable, even weak, by colleagues and commanding officers. This mind-set is prompting some advocates to push for troops to be able to seek alcohol and substance abuse counseling and treatment confidentially, without notifying their commanders.

For its part, the Pentagon wants its military leaders to come forward with their own stories of receiving mental health care. It's all part of a bid to ease any stigma. The key, as was so aptly framed by Mr. Gates, is to convince a culture built on toughness that "you can be tough and seek help for dealing with these problems."