Sign at McConnell Air Force Base’s mental health clinic.

The Pentagon eliminates all language policies that stigmatize mental health issues

An effort is underway at the Pentagon to remove language from Department of Defense policies, regulations and instructions that stigmatizes mental health issues and discourages service members from seeking help.

Deputy Secretary of Defense Kathleen Hicks issued guidance to DoD leadership earlier this month asking them to “go through all documents” to ensure they don’t contribute to negative perceptions of the issues. mental health issues or are not barriers to care.

Hicks said on Tuesday the department wanted to make sure he was not inadvertently adding to the stigma associated with mental health, treatment or care.

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“I’ve posted advice…to remove stigmatizing language…language that was very normal in these posts maybe 20 years ago, but doesn’t reflect where the behavioral health community is today,” Hicks said at a military health forum. hosted by the Washington Post.

“Emissions” include all policies, procedures, regulations and instructions. Under this guidance, those who do not adhere to current medical practice or who do not use negative adjectives to describe mental health issues, behavior or symptoms would be candidates for change, as would any policy that ” implies incompetence in persons with mental or behavioral disorders”. “

Policies that prohibit actions such as promotions or restricting the use of firearms solely because a service member has a mental health diagnosis will also be reviewed, as will those that allow a non-mental health to conduct a mental health assessment of a member.

In terms of language, some of the words that would be removed include terms such as “substance abuse”, which would be replaced with “substance abuse”; “psychiatric establishment”, in favor of “psychiatric treatment establishment”; and “irrational behavior” for something more specific or clinical – “unusual”, “impulsive” or “unusual” behavior.

“Policies should be specific in language to maximize clarity and minimize confusion. In general, general or generic terms, such as ‘mental’, should be used consistently across all policies to avoid confusion or confusion. misunderstanding around the meaning of the word,” the guide says. .

According to the 2018 DoD Health of the Force study, about 16 percent of all military medical appointments, or 1.8 million outpatient visits, were for behavioral health. Diagnoses of mental health issues among troops have remained fairly stable, at around 8% of the total force diagnosed in 2018.

A 2014 study by Rand Corp, a Washington, DC-based think tank, found 203 DoD policies that may contribute to stigma; for example, an Army policy that required soldiers to have “no mental instability to be eligible for draft service.” The policy did not specify what constitutes instability, or whether a troop whose health condition was managed would be eligible for recruitment duty.

“Without policy clarifications and updates, the DOD will be hindered in achieving its policy goal of reducing stigma,” the Government Accountability Office noted in commenting on Rand’s findings.

A review of policies released in 2021 by the Defense Health Agency’s Psychological Health Center of Excellence found that of 285 DoD policies on mental health and addiction, 67% contained language that could potentially be stigmatizing.

The review, however, noted that the DoD had revised its mental health-related policies and moved 59% to adopt updated or neutral language.

Hicks did not specify a time frame for the completion of the work. A Pentagon spokesperson, however, said on Tuesday that the library was “extensive” and the review was ongoing.

The scrutiny comes at a time when the Pentagon has come under fire from conservative politicians and advocacy groups for introducing policies and language aimed at increasing diversity and inclusion in the ranks – critics of the efforts call for a “woke agenda” which they claim undermines combat capability.

But medical experts say words matter, at least when it comes to mental health stigma and language.

In an article published last year in the journal Neuropsychopharmacology, leaders of the National Institutes of Health said negative perceptions of mental health problems and treatment can act as barriers to care and prevent effective treatment.

But efforts to reduce stigma, through careful language, can reduce negative thoughts and biases toward mental health, not just among patients but in the general population.

“This kind of mindset shift is critical to mobilizing the resources needed to deliver quality mental health and addictions services and to eroding the stigmas that prevent people who need these services from seeking or seeking them. receive them. It is also crucial to help educate the general public. on conditions that have long been and continue to be greatly misunderstood,” wrote Dr. Nora Volkow, director of the National Institute on Drug Abuse, and others.

Patricia Kime can be reached at Follow her on Twitter @patriciakime

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