Substance Abuse and Mental Health Treatment Barriers: Military Life vs. Civilian Life Essay


This paper explores the interesting relationship between substance abuse and mental health problems among military and civilian life - Substance Abuse and Mental Health Treatment Barriers: Military Life vs. Civilian Life Essay introduction. As well as stigma barriers to treatment within a military vs. a civilian setting. The article “Substance Abuse and Mental Health Treatment in the Military: Lessons Learned and a Way Forward” written by Katie Witkiewitz and Armando Estrada takes a look at the treatment barriers and how they are not necessarily unique to military settings and/or civilian settings. They also explore how the military setting itself can help destigmatize substance abuse and mental health problems if barriers to treatment are removed.

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Substance Abuse and Mental Health Treatment Barriers:
Military Life vs. Civilian Life
The United States currently has military personal deployed in 150 countries, about 75% of the World’s Nations. Thirty percent of troops returning from Iraq, 300,000 in all, have reported symptoms relating to mental health problems, and/or substance abuse however only about half have sought treatment; why is this? This article, “Substance Abuse and Mental Health Treatment in the Military: Lessons Learned and a Way Forward” explores this question. It’s an interesting fact to say that the rate of substance abuse among military personal and civilians are very similar. Seventy percent of deployed personal reported drinking an average of three drinks a day and 2.9 days of binge drinking within the past thirty days. Similarly, seventy-nine percent of male civilians reported drinking an average of 4.24 drinks a day and 3.4 days of binge drinking within the past thirty days. While alcohol abuse stays consistent between civilians and military personal, illicit drug abuse doesn’t comply. Only two percent of active duty has reported illicit drug abuse, while the civilian population is estimated almost nine percent of illicit drug use. Obviously alcoholism is a problem in the military but that is only at the surface of the magnitude of problems that troops will face when entering civilian life again. Hoge, Auchterllonie and Miliken (2006) estimated mental health problems among troops returning from Iraq at around 30%, 7% suffering from depression, 7.5% suffering from anxiety disorders, and 12% suffering from PTSD. Kessler, Chiu, Demler, and Walters (2005) estimated 26% of American adults suffer from mental disorders, 6.7% suffering from depression, 18% suffering from a type of anxiety order and approximately 25% suffering from PTSD.

According to Clinton-Sherrod, Barrick and Gibbs (2011) research found that only 4% of those at risk for alcohol abuse were enrolled in treatment (2% referred by the Post-Deployment Health Reassessment) and 30% of military personnel at risk for mental health problems were enrolled (14% referred by PDHRA). These statistics don’t differ much from the treatment of the civilian population. According to the National Survey on Drug Use and Health (2009) 8.1% of those who needed substance abuse treatment received it. According to the U.S. Department of Health and Human Services (1999) fewer than 30% of those adults who were suffering from a diagnosable mental health disorder received treatment. These statistic show that treatment has been successful, although the referral and enrollment process seems to be more effective in helping those with mental health problems rather than substance abuse in both veteran and civilian populations. There are many indivual and organizational barriers to treatment that keep veterans from seeking professional help. The differences in military personnel’s perception of substance abuse and mental health problems keep veterans from seeking voluntary help. Britt (2011) Clinton-Sherrod (2011) discovered that soldiers tend to view substance abuse problems as normative behavior that is associated with the military culture, “that is, drink heavily but do not let it affect your performance because if you do it’s your fault”. However mental health problems are viewed as counter to military culture. Soldiers view mental health problems as a sign of weakness; which is not tolerated in the military. Seeking help when mentally disturbed has a negative cogitation in the military, because of the inability to perform, as well as the stigmatization that results from a soldier simply admitting they need psychiatric help.

These barriers to treatment for soldiers have been identified as significant barriers to treatment for civilians as well (Witkiewitz, Estrada, 2011). Tucker, Vichinich and Rippens (2004) found that stigma, negative attitudes toward treatment, the belief that treatment is unnecessary, and economical factors are the most significant reasons invdiviuals do not seek treatment. Therefore, indivual and organizational barriers associated with substance abuse and mental health problems in a military setting are almost the same as those barriers found in civilians. The main difference between mental health problems and substance abuse among civilians and the military is the opportunity for prevention among the military that is not available among civilians. Because, of the organization of the military they are one of the only populations of people that have an opportunity to enroll 100% of its members in substance abuse and mental health programming. The Institute of Medicine and the National Institute of Drug Abuse (2003) believes in a four-tier preventive intervention classification system. If this tiered system was used among society at large the benefits could be imaginable. The first tier, universal prevention targeted at a large population, focuses on educating those about the problem and skills to prevent it. The second tier, selective prevention focuses on those whose risk for developing mental problems or substance abuse. The third tier, indicated prevention’s goal is identifying those who exhibit early signs of mental health problems and substance abuse. Finally, tertiary prevention targets those who already exhibit problematic levels of substance abuse or mental health problems and need relapse prevention or counseling.

This tier system could be successful within the military and improve the lives of soldiers when they enter civilian life. (Witkiewitz, Estrada, 2011). Substance abuse and mental health problems are inevitable whether you are in the military or a civilian, because not one of us is “normal” or susceptible to them. Each and every one of us is fighting some type of battle. I found this article compelling how they compared civilian and military substance abuse and mental health problems. I believe that it takes a certain type of person to vultinarily enter into the military. Although substance abuse and mental health problems can stem from any end of society they tend to be especially prevalent within a military setting. Military personnel are drawn from civilian society and relocated overseas to fight a relentless battle. Wouldn’t that situation drive most of us to dose our worries in a bottle of whiskey? Military personnel have a unique job in itself, to protect and defend the United States. Yet, they enter back into civilian life with life altering problems and images that will haunt them for life. It would be a lie to say that war itself doesn’t drain the life out of its soldiers. A war zone is not designed to feed a healthy mind but break that mind down. War corrupts its players. Although civilians and soldiers experience the same amount of mental health problems and substance abuse, the military has the control and organization to stop these problems before they become out of hand.

Witkiewitz, K., & Estrada, A. X. (2011). Substance Abuse and Mental Health Treatment in the Military: Lessons Learned and a Way Forward. Military Psychology, 23(1), 112-123. doi:10.1080/08995605.2011.548651

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