Monday, April 13, 2015

Army substance abuse programs "in disarray"

One way to reduce alcohol and other substance abuse in the military is to recruit and retain more females.


"Twenty thousand soldiers who seek help each year at Army substance-abuse clinics encounter a program in such disarray that thousands who need treatment are turned away and more than two dozen others linked to poor care have spiraled into suicide, a USA TODAY investigation has found.
The Army's transfer of substance-abuse outpatient treatment from medical to non-medical leadership in 2010 has led to substandard care, the mass exodus of veteran personnel and the hiring of unqualified clinic directors and counselors, according to senior Army clinical staff members and records obtained by USA TODAY.
"This is the crux of the whole thing," said Wanda Kuehr, a psychologist who agreed to speak out about the problems after retiring Feb. 2 as the program's director of clinical services. Non-medical managers want to "get the reports in on time and fill the slots. They think that makes a good program. Our goal is to give treatment to soldiers. And (the bosses) see that as inconsequential ... What's happening to soldiers matters and the Army can't just keep pushing things under the rug."
Five current staff who described similar problems in interviews declined to be identified for fear of Army reprisals. They "are very frightened if they tell the truth they will lose their job," Kuehr says. "It's sad when we have (such) a climate."
The Army emphatically denies that its substance-abuse treatment efforts have declined.
One tragic result: the Army estimates that since 2010, about 90 soldiers committed suicide within three months of receiving substance-abuse treatment. At least 31 suicides followed sub-standard care, according to tabulations by the clinical staff, although they did not specifically link the deaths to poor treatment.
In a 2012 case, Army managers hired an unlicensed counselor at Fort Sill in Oklahoma over the objections of senior clinical personnel. The counselor began seeing patients and gave a "good" rating to a soldier who hanged himself two hours later, according to an internal Army report provided to USA TODAY.
An Army survey over the past year finds that 104,000 soldiers — one in eight canvassed — report serious drinking problems.
An Institute of Medicine panel of scientific experts on substance abuse warned in a 2012 report that the military faces a public health crisis in drug and alcohol abuse.
Non-medical supervisors have told counselors to take time away from sessions to shovel snow, mop floors, clean toilets and take out the trash. A 2013 work memorandum at Fort Bragg in North Carolina reminded counselors to clean their mops and buckets after using them.
Attrition has been high. Scores of psychologists and social workers who served as counselors or clinical directors at dozens of Army bases began resigning, retiring, shifting to other positions or taking new jobs with the surgeon general or the Department of Veterans Affairs since the change in commands.
About half the 48 counseling positions at Fort Hood in Texas, the Army's largest base, are unfilled, increasing "risk of negative patient outcomes, provider burnout and further clinical staff loss," according to a Jan. 13 Army memo."

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