The Urgent Need for Confidential Psychological Care for U.S. Military

Soldiers' concerns about retribution and stigma make many reluctant to see military psychologists, and their health insurance does not pay for them see civilian doctors.

I patiently waited through two seven-month deployments for my husband to come home from Afghanistan. Every time we talked on the phone, he said he was fine. He'd say, "If you pretend everything is okay, then after a while you begin to believe it and that's how you make it home." 

That seemed to work in Afghanistan, but when he returned home the bottled up emotions poured right out. Almost every single day for seven months after returning home, Tyler would have outbursts. The smallest things, that never bothered him before, would set him off -- he would be laughing with me one minute, punching walls the next. We patched up numerous holes in the wall, bought new furniture, and even bought a new car windshield due to his rage.  

His fellow Marines are enduring the same. It's not uncommon for us to get a call to pick up some one from his platoon who got kicked out of the bar for throwing tables, whose wife kicked him out of the house for hitting her, or who was unconscious in the shower from alcohol poisoning.

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People call my husband a "big teddy bear." He stands 6'2", weighs 225 pounds, and gives out hugs like nobody's business. We fell in love in high school after he lent me his jersey to wear to the school football game. Prior to deploying, Tyler loved spending time sledding with our nephew or building sand castles with our niece. Now it's very hard for him to spend time with them, because he fears having an outburst in front of them. He keeps visits brief. 

His lack of talking had never been an issue, until he had so much he wanted and needed to say about what he experienced while deployed, but physically couldn't.

(Finbarr O'Reilly/Reuters)

As soon as the anger began, I suggested that we see a psychologist. He stormed out of the room. He said that he could fix the problem himself, in due time. But it only progressed. A few months later I brought up the idea of seeing a psychologist a second time. He realized that the problem had gotten worse, and he didn't know what to fix or how to fix it. After six more months of outbursts and with a great deal of courage, he finally acknowledged that he needed help.

I thought that was victory, but it was only the beginning.

Fearing that "the Marine Corps would find out," Tyler refused to see a psychologist on base. In the Marine Corps, he told me, getting help means weakness. What's more, the psychologist cannot guarantee confidentiality. Here he has this free health care that would cover all of the psychological treatment we could ever hope for -- and even all of the new PTSD treatments -- and he absolutely refuses to take advantage of it because of the lack of confidentiality.

I don't blame him at all for refusing to seek help within the military, and I know that many other Marines feel the same way. I spoke with one of Tyler's friends regarding the subject, who I'll call Corporal Johnson, and asked him if he thought that he or a fellow Marine would be comfortable seeing a military psychologist if they needed to. He told me, "I have seen many devil dogs that have chosen not to see a military psychologist. They say they are confidential, but working for the military, we know that they cannot have that right. You're afraid if you say the wrong thing to a therapist they would go to your chain of command and take you away from your brothers that you have spent day and night with since enlistment. We are also afraid that our chain of command could then label us as weak and not give us the promotions that we work so hard for and deserve."

The possible repercussions mean military psychologists see mostly wives, children, and vets. Enlisted men do not want to go. Another one of Tyler's fellow Marines told me, "You couldn't pay me to go to a military psychologist. Isn't the whole point of seeing a psychologist to 'open up'? Why would we go to them when we would just have to tell them lies?"

I understood my husband's fears, and suggested that we see a civilian psychologist. But since the military benefits program (Tricare) doesn't cover that, he suggested we wait it out. 

We waited, and then we waited some more. Last month, he had ripped everything off of our bedroom walls. The next morning, he had felt down on himself that he hadn't "kicked it" yet. I got a recommendation for a civilian psychologist who specialized in PTSD, and he agreed to go.

(Finbarr O'Reilly/Reuters)

I called Tricare to figure out our options, and the told me that all Active Duty servicepeople can only see military psychologists, and that although Tyler could request to see a civilian, he could only do so if the military did not have the means to provide for him. Right away, it was obvious to me that we would not be able to see a civilian psychologist unless we paid out of pocket.

With Tyler finally on board for receiving care, and even excited about the thought of understanding himself better, I haven't had the heart to tell him that so far I've failed to find an alternative option that we can afford. He thinks we're just waiting for an appointment. I am a full-time student and nanny when I can; however, the only consistent paycheck we receive is his. The military does not pay nearly enough for us to be able to pay for out-of-pocket care.

I called the civilian psychologist back. She said that other than paying out-of-pocket, which we couldn't afford, we could use my insurance, which isn't Tricare, to cover couples therapy. This is obviously not ideal, since it require me to be in the room with him, but at this point, it's the only option available to us and we'll take it. I am hoping that it will somehow lead to the one-on-one therapy that he needs and deserves. He is a hero, and deserves to be taken care of physically and mentally when he returns from war.

My husband and most of his friends were roughly 19 years old the first time they stepped foot in Afghanistan. Most 19-year-olds' greatest fear is their GPA at the end of the school semester, and theirs was living to see their twentieth birthday. With all they have seen and experienced physically and emotionally, it is not a surprise that many come home with destructive outbursts. Another Marine that I spoke with, Corporal Fisher, has also served two deployments, and he returned home with more problems than he and his wife could handle. I asked him what problems he experienced upon returning home and he said, "I was constantly angry, and would drink until I blacked out. This wouldn't have been as big of a deal if I would just fall asleep like most people, but the alcohol would make my anger come out and I would try and start fights with everyone, break everything around me, and scream at my wife because I didn't recognize her. When I would do this, I would think that I was still in Afghanistan, and ask for my 'brothers.' My wife would hide and call my friends to come calm me down and put me to sleep."

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When I asked Tyler if Fisher had gotten help, he laughed at me and said that they had been looking for help that they could afford for months. He too, refused to seek help within the military for fear of his higher-ups finding out.

America has seen an epidemic of PTSD since the war in Iraq and Afghanistan began. These men and women fighting need someone they can trust to tell their stories to when they return home. If they had the option to receive confidential care as soon as they returned home, then we would not have as many American heroes living the entirety of their lives fighting a battle within.

*All names have been changed to protect confidentiality.