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Pentagon Scrubbing All Policies of Language That Stigmatizes Mental Health Conditions

Attempts are being made at the Pentagon to remove stigmatizing language from Department of Defense policies, regulations and instructions mental health circumstances and discourages service personnel from seeking help.

Deputy Defense Secretary Kathleen Hicks issued guidelines to the DoD leadership earlier this month directing them to “search all records” to ensure they don’t contribute to a negative perception of mental illness or interfere with care.

Hicks said Tuesday the department wants to make sure it doesn’t inadvertently add to the stigma associated with mental health, treatment or care.

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“I have released guidelines… to remove language that stigmatizes… language that may have been very common in those issues 20 years ago, but is not reflective of where the behavioral health community is today,” Hicks said during a military health forum hosted by The Washington Post.

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

Policies that prohibit actions, such as promotions or limiting the use of firearms, solely because a service member has a mental health diagnosis will also be reviewed, as will any policy that allows a non-mental health professional to undergo a mental fitness assessment to make a member.

In terms of language, some of the words that would be dropped include terms such as “drug abuse”, which would be changed to “substance abuse”; “mental institution”, in favor of “mental treatment facility”; and “irrational behavior” for something more specific or clinical — “unusual,” “impulsive,” or “uncharacteristic” behavior.

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“Policies should be precise in language to maximize clarity and minimize confusion. In general, broad or umbrella terms, such as ‘mental’, should be used consistently throughout the policy to avoid confusion or misunderstanding of the meaning of the word the directive states. .

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

A 2014 study conducted by Rand Corp, a Washington, D.C.-based think tank, found 203 DoD policies that may contribute to stigma; For example, a Army policy requiring soldiers not to have “mental instability to qualify for”. recruitment duty.” The policy did not state what constitutes instability, or that a troop whose health status was being managed would be eligible for recruiting service.

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

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

However, the review noted that DoD had revised its mental health policy and changed it to 59% to adopt updated or neutral language.

Hicks did not specify a time frame for completing the work. However, a Pentagon spokesman said on Tuesday that the library is “massive” and that the review is underway.

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The investigation 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 its ranks.

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 at the National Institutes of Health said negative perceptions of mental illness and treatment can be a barrier to care and prevent effective treatment.

But efforts to reduce stigma, through careful use of language, can reduce negative thoughts and prejudices about mental health, not only among patients but among the general population.

“This kind of mindset change is critical to mobilizing the resources needed to deliver high-quality mental health and addiction services and eroding the prejudices that prevent people in need of these services from seeking or receiving them. It is also crucial to educate the wider public about conditions that have long been and still are misunderstood,” Dr. Nora Volkow, director of the National Institute on Drug Abuse, and others.

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

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