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Army expanding mental health program despite research

Oct. 7, 2013 - 06:00AM   |  
A U.S. soldier is silhouetted at a security post during a presence patrol around Forward Operating Base Fenty in Nangarhar province, Afghanistan, Aug. 22.
A U.S. soldier is silhouetted at a security post during a presence patrol around Forward Operating Base Fenty in Nangarhar province, Afghanistan, Aug. 22. (Sgt. Margaret Taylor / Army)
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The Army is expanding a $50-million-per-year program created in 2009 to help soldiers withstand mental illnesses such as post-traumatic stress disorder despite research by its own scientists showing it does nothing to reduce PTSD.

Study authors said the training created small, indirect benefits but did not affect PTSD rates. Their report was posted online earlier this year and scientists recently discussed their findings with USA Today.

“I wish this was the magic bullet,” said lead author Peter Harms, an assistant professor of management at the University of Nebraska. “I wish we found huge findings. I think we found reasonable things.”

About 900,000 soldiers receive instruction each year in the program, originally called Comprehensive Soldier Fitness or CSF. It is being expanded this year under the name Comprehensive Soldier and Family Fitness and will cost $75 million annually by 2019.

It teaches soldiers and family members coping strategies such as keeping a positive or optimistic outlook on life or cultivating strong social relationships. Army leaders say it gives soldiers the tools to become emotionally resilient.

“Most people you talk to, who have been through it, will say it’s a game changer,” said Gen. John Campbell, the Army vice chief of staff.

But it has been controversial for years. Critics said it was adapted from a program designed for children and adolescents and has never been scientifically shown effective in reducing mental illness among soldiers who have been in combat.

The Army internal report that was posted online was the first somewhat rigorous effort to test CSF’s effectiveness in preventing mental illness.

The Army study shows no direct link between the CSF training and reducing rates of diagnosis for depression, anxiety and PTSD.

It did show a small, indirect benefit. Soldiers who trained in areas of optimism and adaptability and who scored well in those traits showed a 13% reduction in all three illnesses when they were grouped together into a single statistical category.

But there was no direct or indirect impact on PTSD, co-author Paul Lester said Monday.

An Army slide program used to promote CSF for commanders did not make that distinction, saying only that resiliency program produced “13% fewer diagnoses of anxiety, depression and PTSD.”

Soldiers who took the training had significant fewer diagnoses for drug and alcohol abuse, the study said.

However, critics of the training say using the number of diagnoses to determine training’s benefit misses large numbers of soldiers who may or may not have developed substance abuse problems. The stigma from seeking such treatment often leads soldiers to decline seeking help.

For example, this study found that only 2% of soldiers received diagnosis for substance abuse. Critics say that particularly alcohol abuse has been found to be far higher and that using diagnoses to measure success of CSF is a mistake.

“The conclusions that (Army researchers) drew were not supported by their findings or data,” says Bill Nash, a psychiatrist and scientist who studies combat stress in Marines.

Still, other critics, such as Shelley MacDermid Wadsworth, director of the Military Family Research Institute at Purdue University, called the study results a “good beginning.”

It’s a good idea for the Army to teach emotional coping skills to soldiers, she said. “I think the logic of it makes sense,” she said.

The resiliency program was created in 2009, at time when mental illness and suicide were spiraling higher in the Army and leaders were grasping for answers. Those rates have continued climbing to record levels in 2012.

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