A Navy Psychologist on the Military and Mental Health

Sunday, May 17, 2009

Midway through her 2004 deployment to Iraq's Anbar province, Navy psychologist Heidi Kraft was e-mailing her husband about her experiences, and the message somehow turned into verse. The poem became the basis for her memoir "Rule Number Two: Lessons I Learned in a Combat Hospital" -- lessons that she revisited last week following the shooting at a combat stress facility in Baghdad. Kraft, who left active duty after nine years in the Navy and now treats combat stress patients, spoke with Outlook's Rachel Dry about how the military handles mental health and why PTSD can be like a sprained ankle. Excerpts:

Last Monday, Sgt. John M. Russell allegedly walked into a combat stress facility at Camp Liberty in Baghdad and opened fire, killing five service members. What did you think when you heard about the shooting?

My heart sank. I was so terribly saddened to hear it. As a provider, I can understand how something like this might have happened. Certainly if someone expresses either suicidal or homicidal thoughts, that person is categorized as a psychiatric emergency and steps are taken to stabilize that person. Sometimes those thoughts are not expressed in a way that makes it very clear what you're dealing with, and sometimes there's nothing to be done.

After the attack, the military announced that it would investigate whether it offers adequate mental health care. What would you want to see come out of that study?

I would hope that we would be able to figure out the very best place for providers to be and the very best way to reduce stigma so that everybody feels they can come.

How has the military's focus on mental health changed since your time in Iraq?

There's such an increased awareness, not just in the medical communities of the military but in the line -- in the warriors themselves. The leadership is really behind the idea that what we're talking about here is an injury, not an illness. That these are normal people in an extraordinary circumstance, under extreme pressure and possibly exposed to trauma, and that those people can be injured. Just like those same normal, healthy people could have turned their ankle. Those injuries require both rest and proper treatment. But they can and will heal and actually have the potential to be better, more resilient.

How so?

Just like if you were to go through [physical therapy] for a badly sprained ankle -- your ankle might get stronger. And by taking away the idea of mental illness, we're trying to reduce the stigma. There's a huge, huge stigma in the military culture about seeking mental health care and treatment, and that's a culture that's longstanding, so it's quite a battle against it.

Is there still a sense that if you're planning a career in the military, you should not be seeking treatment?

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