County seeks ideas for helping military, families

By: DENIS DEVINE - Staff writer
Counselors say persistent 'stigma' crippling ability to help returning troops | Wednesday, February 20, 2008 11:49 PM PST ∞

OCEANSIDE -- At a public forum here this morning, San Diego County health officials plan to ask what new mental health programs they should offer for active-duty military, veterans and their families.

But some people who provide mental health care for the county's large military population say any new programs will have to overcome the stigma that prevents troubled troops and their families from seeking help.

A recent study suggested that post-traumatic stress disorder, the most commonly diagnosed mental disorder among veterans, affected about 13 percent of those returning from Iraq and 6 percent from Afghanistan.

Marine Corps statistics released to the North County Times show a nearly 600 percent increase in the number of Marines diagnosed with PTSD since the Iraq invasion -- from 271 in 2003 to 1,869 in 2007. The Marines credit more education and improved diagnoses for the rising rates of diagnosed mental illness among combat veterans.

New surge of funds

Even as California's fiscal crisis threatens big cuts to existing mental health services, San Diego County is awash in millions of new tax dollars designated for new mental health services.

The director of the county's adult and children's mental health departments, Alfredo Aguirre, on Wednesday pegged this pot of new funds at about $80 million in the coming fiscal year. Those funds come from 2004's Proposition 63, a voter-approved 1 percent tax on millionaires' annual income to fund new mental health care programs.

This influx of money can't be spent on existing mental health programs, but must be directed toward new programs. So the county is casting about for ideas how to best spend a large chunk of new cash.

The workshop seeking ideas for military mental health services takes place from 10 a.m. to 2 p.m. today in the community rooms at Oceanside Civic Center, 330 N. Coast Highway.

Of the $80 million the county will get from Prop. 63 next year, Aguirre said about $16 million would be spent on new programs for prevention and early intervention. That money would be split among eight targeted populations, including active military, veterans and the families of both, Aguirre said.

Aguirre said several times during a Wednesday phone interview that the county wasn't seeking to replace or repeat the mental health services provided by the U.S. Department of Veterans Affairs or the county's military bases, including the Marines' Camp Pendleton and Miramar air station. He said his office had been working with VA and military officials, including representatives of the San Marcos Veterans Center, to develop programs.

The acting head of the San Marcos center could not be reached for comment Wednesday.

Fear of being labeled

The head of Operation Homefront's San Diego chapter said Wednesday that she was unaware of today's meeting, and when informed of it she said she was "glad they're having it, though."

"With 30 percent of military returning from combat being diagnosed with PTSD, it's something they need to address," said Jae Marciano, whose Operation Homefront chapter is based in Miramar. The national nonprofit was established in 2001 to support service members and their families.

Marciano said one of the group's primary obstacles is the "mystique that's built around getting help" in the military community.

The county would have to call its military-serving programs "something else," she said, something other than "therapy."

Returning troops "don't want to be labeled sick," Marciano said. "They don't want to be labeled disabled. They just want to be able to do their job. But that gets really hard, especially when command is opening their case file and could put their promotions on hold."

Marciano noted a gap between military brass' stated support for troops receiving mental health treatment and the experiences of the rank and file.

"We know the command supports everything that we do, but when you talk to the families and what goes on between their supervisors on the ground, when they're out doing their daily jobs, it's a much different message," she said.Treat 'em all

That message was echoed by Robert Bornt, an Oceanside-based family therapist who works with active-duty military, veterans and their families.

Bornt's "Operation Recovery" program involves veterans in manual labor projects on the grounds of the Mission San Luis Rey retreat center that are designed to double as work force training and a kind of unintrusive therapy, he said.

Bornt was stunned to learn of the county's workshop.

"I'm quickly becoming an advocate for the military active duty and veterans that have no voice in what's going on," he said. "It's just crazy."

What Marciano called a "mystique" Bornt called a "stigma" that "runs so deep, they're afraid to say anything."

"Wives believe their husbands will be deployed quicker if they say anything about stress," he said. "Command ridicules and persecutes them. The peer pressure is enormous to be a man and suck it up."

Bornt said the county's effort was a "lost cause unless they get buy-in from federal government, from the military command."

Because of the stigma attached to mental health treatment, Bornt said troops quickly figure out how to tell a counselor exactly what he or she wants to hear.

"The second they hear that you're a therapist and they go into a room with you, they already know what to do with you," he said. "If soldiers know that going to a therapist will get them diagnosed, you're going to get cured as soon as you learn what you need to say to get cured."

Bornt had this recommendation for the county, the military and VA: Bring all troops returning from combat deployment into an "emotional debriefing ... where everyone, from the toughest to the weakest, they all come through a six-week program, to just look at who they are and how they organize their emotional experience."

Only by forcing all troops to assess the harrowing experiences they just survived would the military be able to eliminate the stigma. After such a debriefing, returning troops could be "thrown into a therapeutical model where somebody can whack 'em with a diagnosis," Bornt said.

More workshops next week

Next week, the county will continue its brainstorming sessions with more workshops on what new programs should be offered for other targeted groups.

A Tuesday workshop at the Radisson Hotel in Rancho Bernardo will focus on how the county can better serve American Indian communities in rural North County and East County.

On Wednesday, another workshop in Oceanside, this one at the North Coastal Regional Center at 1701 Mission Ave., will solicit ideas for new programs to serve people with "co-occurring disorders," which Aguirre described as problems such as substance abuse in addition to mental illness.

For more information on these workshops, contact Debra Fitzgerald at (619) 563-2753 or debra.fitzgerald@sdcounty.ca.gov, or Ann Zellers at ann.zellers@sdcounty.ca.gov or (619) 563-2772.

People not able to attend the forums may provide their input online at www.sandiego.networkofcare.org.

-- Contact staff writer Denis Devine at (760) 740-5415 or ddevine@nctimes.com.

County mental health workshops

San Diego County is seeking input on what new mental health programs it should offer for the following groups:

"Native American communities"

10 a.m. to 2 p.m. Tuesday

Radisson Suite Hotel, 11520 W. Bernardo Court, Rancho Bernardo

"Co-Occurring Disorders," or people who have multiple mental health issues

10 a.m.- 2 p.m. Wednesday

North Coastal Regional Center, 1701 Mission Ave., Oceanside

-- For more information on both workshops, contact Debra Fitzgerald at (619) 563-2753 or debra.fitzgerald@sdcounty.ca.gov.

On the Net:

People not able to attend the forums may provide their input online at http://www.sandiego.networkofcare.org.