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Accessing Mental Health Services in the Military – is a Double-Edged Sword!

The military is taking a more proactive stance toward supporting service members’ mental health in recent years and these changes are long overdue!  At so many points in my career as a soldier, I encouraged personnel struggling with a wide range of issues in their lives to consider seeking out behavioral health support and nearly all the recommendations were rejected outright – even if the person acknowledged that this resource would likely be useful for them.  

This is the nexus of the double-edge!  A service member’s well-being, focus, concentration, and work are being impacted negatively by overwhelming life circumstances and on the one hand, while they consider the potential value of accessing behavioral health services, their desire to get support is immediately met with the other “sword-edge”, desperate fear, or concern that their decision to get mental health assistance might negatively impact their career.  While this may seem incredibly prejudicial and extreme, these fears are not without merit.  

The military has been making structural adjustments to address the “edge” associated with the Security Clearance process since 2008.  This statement was included in the July 2008 version of the Security Clearance Questionnaire: “Mental health counseling in and of itself is not a reason to revoke or deny a clearance.” As recently as 2016, additional caveats were included on the Security Clearance Questionnaire to further reduce the stigma and fear associated with seeking support from mental health professionals: “You are allowed to answer “no” if:

  • You have received mental health treatment that strictly relates to adjustment from combat service.
  • You have received counseling that relates to family, grief, or marriage issues (and that is not court-ordered or violence-based).
    • You were a victim of sexual assault and received counseling that relates to that trauma

Even if you answer “yes” to Question 21, the new rules state that you cannot be denied an interim 

security clearance based on that answer.” An October 2020 flyer published by the Defense Counterintelligence and Security Agency boldly states: “Seeking mental health services does not affect one’s ability to gain or hold clearance eligibility. Adjudicators regard seeking necessary mental health treatment as a positive step in the security clearance process.”  

Military leaders are publicly encouraging personnel to take their mental health as seriously as they take their physical health, most recently demonstrated by these statements from the Sergeant Major of the Army, SMA Michael Grinston at the Health and Holistic Fitness Conference held in April: “We don’t practice mental resiliency until something breaks and we go to behavioral health,” Grinston said.  The sergeant major said going to behavioral health is good and should be encouraged when a soldier needs it.”

Why does any of this matter to TELL mental health practitioners?  I hope that this short review of the real structural hurdles that service members may have had to face as they evaluated whether to come to therapy at all, will equip you with meaningful insights into some of the resistance, hesitancy, suspicion, and other attitudes or projections you may experience as you begin to build the therapeutic relationships with service members who are with you in person or on the screen.  Your work is a crucial step in softening the “other edge” of this double-edged sword, as you simultaneously support them in their therapeutic goals.

Samantha B. Ross, LMFT, Ed D

Lieutenant Colonel, US Army (Retired)