February 28, 2011

Mental Health Program For National Guard, Reservists Faces Budget Cut

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Because of money problems, the state is cutting its groundbreaking counseling and support program for National Guard soldiers, Reservists and their families, according to Jim Tackett, director of Veterans Services in the state Department of Mental Health and Addiction Services.

This comes at a time when officials had hoped to expand the program to also include enlisted Armed Forces and families, he said.

The program, called the Connecticut Military Support Program (MSP), was the first of its kind in the country when it was established in 2007 and is still considered unique, but is running out of money.

The commissioner of mental health has helped by allocating up to $175,000 from the department budget to keep it operating another year, but that and what remains from the original funding won’t pay for the existing level of services, Tackett said.

The program was started to help deployed Connecticut National Guard members, Reservists, and their families deal with mental health and substance abuse problems, usually referred to as “behavioral health.” Some issues they face include depression, anxiety, post-traumatic stress disorder (PTSD), marital problems, arrests for driving under the influence, separation issues faced by children, and stress resulting from war zone service and home coming.

The program connects “citizen soldiers” and their families with licensed clinicians who provide free, confidential counseling. There are 425 clinicians in the program and a soldier or family member is given three names to select from when they phone a 24-hour call center seeking help.  It also employs 26 clinicians who are embedded with National Guard units, and provides money for gasoline for clients who can’t afford to buy gas to get to their counseling sessions.  Clinicians include social workers, psychologists, marriage and family therapists, and advance practice registered nurses.

The shaky financial situation will force a reduction in the number of clinicians embedded with National Guard units and will likely result in a reshuffling of the current embedded system, Tackett said.  The goal is to have a clinician in each of the guard units in the state, he said.

Decisions about specific cuts are expected to be made jointly by the state mental health department and the National Guard in the next month or two, he said. Some proposals under consideration include limiting embedded clinician coverage to a certain period after a deployment and removing clinicians from units that aren’t scheduled for another deployment.

One change to take effect in April will place a six-month per person limit on participation in the gas care program that helps needy soldiers and families with the costs of driving to counseling sessions.

The gas program started in March, 2008 after participants were dropping out of treatment because they couldn’t afford to pay for gas, Tackett said.  There have been 1,028 uses of gas cards since the program began and the new cap basically cuts it in half, he said, adding that most gas cards have a $25 value.

Tackett explained that the program will continue to focus on outpatient counseling, its “core service.” The need for counseling arises from the strain that repeated deployments, especially to Iraq and Afghanistan, have on soldiers and their families.  The MSP was designed to: address resulting problems, fill gaps in services to families of National Guard members and Reservists; and to provide confidential counseling in contrast to the Veterans Administration (VA) which may pass along information from treatment sessions for behavioral health problems to soldiers’ superiors.

The MSP was established by the legislature with $1.4 million from the sale of the former Fairfield Hills State Hospital in Newtown. Originally, $535,000 was given to Yale University to do research on the psychological aftereffects of war service so that the program would be responsive to needs found in the study. The remaining $865,000 went to the program.

Tackett explained that former Mental Health Commissioner Thomas A. Kirk, Jr. decided that more money should be used for the program, so he asked for Yale to refund some money and it gave back $117,000. Current Commissioner Patricia Rehmer designated up to $175,000 from her budget for the fiscal year which begins July 1.  So the program is left with the Yale giveback, the $175,000 and the $103,000 from the original allocation, Tackett said.

The cuts follow unsuccessful efforts in Congress to expand the Connecticut program to include enlisted service members in the Armed Forces and their families. Tackett explained that the MSP has had to turn them away when they seek services because state law only authorizes it to serve National Guard soldiers, Reservists, and their families.

The Connecticut Congressional delegation proposed a $500,000 earmark in the 2011 Defense Authorization Act to address this gap.  But, Tackett explained that it was removed “at the 11th hour” because Republican legislators objected to having earmarks in the budget.  President Obama has also said that he would veto legislation that contained earmarks. Tackett expressed hope that the new initiative to help military families being promoted by First Lady Michelle Obama and Dr. Jill Biden will result in more funding for the Connecticut Military Support Program.  Specific proposals are expected to be announced in March.

In Connecticut, there are about 4,300 National Guard members and approximately 1,600 people in the Reserves, Tackett said.

A breakdown of diagnoses at outpatient counseling through MSP is: 38.9 percent, depression; 17.1 percent, PTSD; 14.9 percent, anxiety; 13.7 percent, marriage and family counseling; 8.7 percent, substance abuse; 11.2 percent were children and adolescents, most dealing with adjusting to having an absent parent in a war zone; and two spouses were seen for bereavement issues after a spouse was killed on active duty.

Tackett said a major challenge of the program is reaching Reservists and their families because their commanders are out of state. The Connecticut National Guard, on the other hand, is based in Hartford. There are no clinicians embedded with Reserve units.  Tackett said Reservists take advantage of MSP counseling services “to the extent that they know about it.” He added that “participation would be much greater if we were more successful in hooking up with every unit when it comes back from deployment.”

As of December, 2010, a total of 2,431 people called the MSP with 1,116 receiving counseling services and 1,412 receiving information and advocacy services. In addition, 315 soldiers were referred directly to the VA for complex issues such as bipolar syndrome, and major cases of depression and PTSD.

 

 

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