Addressing the mental health concerns of service members
Mental health is a hot topic of discussion within the health care community. More people are gaining access to, and taking advantage of, mental health services. As such, pharmacists will have an active and increased role in the treatment of patients going forward. The U.S. Armed Forces is a great example of this model as they have provided pathways for thousands of service members to address mental health issues.
To better frame this discussion, I interviewed a pharmacist and two student pharmacists (who are all either current or former members of the U.S. military) on perception, access, and treatment to mental health care services within a military setting. I interviewed: Jeffrey Neigh, PharmD, MBA, MHA, BCPS, of the U.S. Army, Deputy Director, Pharmacy Service Line and recent APhA Federal Fellow; John Soldner, a third-year PharmD candidate at the Samford University McWhorter School of Pharmacy and former Staff Sergeant in the U.S. Marine Corps; and Travis Pagareski, a third-year PharmD candidate at the University of Toledo College of Pharmacy and Pharmaceutical Sciences and a current Sergeant in the U.S. Army Reserve.
Jason Gaines (JG): How is mental health perceived in the military?
Jeffrey Neigh (JN): Mental health treatment used to have a terrible stigma within the military. Soldiers who expressed feelings of depression or suicide were labeled weak and/or not fit for military service. Thankfully, much has changed. While I am sure that some of the stigma still exists, the military is becoming active in addressing mental health issues by openly advocating for service personnel to seek treatment.
John Soldner (JS): During my experience, post-deployment, posttraumatic stress disorder (PTSD) related to combat was the primary mental health disorder encountered and resources were made available to soldiers. However, most marines felt weakened by being labeled, thus would lie in order to return to combat. It wasn’t until after returning from deployment that many marines would realize the consequences [of not seeking help] and battle mental health disorders.
Travis Pagareski (TP): During my time, mental health has been a huge topic in all aspects of the military and was perceived as a general concern. Anxiety usually started to set in as units prepared for overseas deployment. Due to the stresses of military life, I know soldiers who are currently taking anxiety medications. For many, it has become too difficult to turn off the military side of who we are.
JG: What are some of the current treatment options for military personnel and veterans suffering from mental health disorders?
JN: In the Army, we have taken great strides to make mental health resources more accessible to soldiers. Rather than have soldiers come to the hospital or clinic to seek out behavioral health services, there are now behavioral health providers located on site where troops work and train to ensure accessibility. In areas that are short of behavioral health providers, the military is leveraging telehealth technology to provide behavioral health services remotely. Soldiers now have multiple options to address these health concerns as the military continues to enhance services to meet demand.
JS: The VA system has improved over the years. Since most marines suffer from PTSD, there are techniques for assessing the cause and treating veterans. Trauma-focused psychotherapies are a common treatment. These techniques utilize methods to help veterans process their traumatic experience. The initial treatment usually focuses on behavioral techniques before moving to pharmacotherapy.
JG: How do military pharmacists play a role in treatment?
JN: Pharmacists play a vital role as a member of the care team. We typically have a clinical pharmacist assigned to each soldier-centered medical home to provide treatment to patients. Additionally, we screen our active duty population on a monthly basis and identify patients at risk for polypharmacy concerns due to opioids, CNS agents, and psychotropics. Clinical pharmacists meet with high-risk patients for one-on-one counseling to review their drug regimen and identify areas of concern.
TP: Pharmacists are active in incorporating medication therapy management into the patient care experience. By actively working with soldiers to identify mental disorders such as depression, PTSD, and anxiety, pharmacists are difference makers when it comes to providing adequate care.
Begin Your Legacy
This issue of Student Pharmacist features articles focused on personal mental health issues, which I am sure you will find interesting. Remember that an important aspect of APhA–ASP President Michael Murphy’s Begin Your Legacy theme is to not neglect your personal health and your mental well-being. How well you take care of yourself contributes to your legacy.
Jason Gaines is a final-year PharmD candidate at the Mercer University College of Pharmacy and the 2017–18 APhA–ASP Speaker of the House.