Combat veterans seek mental health care

...and sometimes they don't find it. According to a study in the current Journal of the American Medical Association, more than a third of Iraq veterans seek mental health services in the year after returning from deployment. The study links combat experiences with the need for post-deployment services. But what's most interesting in the article is what it doesn't say.

Consider this quote in the article's summary: "More than 50% of those referred for a mental health reason were documented to receive follow-up care." Though it's presented in positive terms, what it actually says is alarming: Almost half of those who seek help for mental health issues aren't getting it.

If you or a friend or family member are a combat veteran and need mental health services, this information may be useful to you: First of all, many local therapists (myself included) and agencies offer reduced-fee services for clients with lower incomes. This way everyone can benefit from counseling, even those who think they can't afford it. Second, for combat veterans who have experienced trauma and have spouses or significant others, there is reason to believe couples therapy may be the best treatment. Creating a safe and supportive couple relationship can serve to both reduce the impact of trauma on the survivor, and decrease the chances that the survivor's partner will be secondarily traumatized or feel excessively burdened by living with the survivor. Emotionally Focused Therapy has been specifically developed and studied as a couple-based response to trauma, and works well; I'd recommend seeking out a therapist who offers this approach. (And--surprise--I'm one of them. But I'm not the only one, and am happy to make referrals if you wish.)

Paying couples to get married?

In an effort to motivate poorer couples to get and stay married, Kansas Sen. Sam Brownback has helped institute a pilot program in the District of Columbia that actually pays couples up to $9,000 for getting married. Brownback has said he hopes the program will eventually be implemented nationwide. The money isn't simply a handout--couples in the program are required to take additional steps like buying a home or expanding a business to qualify for federal matching funds. Nonetheless, it's designed with the goal of supporting marriage. "The welfare system penalizes marriage," Brownback tells USA Today, and that's hard to argue with. But is this the right solution? In context with Brownback's other efforts to reduce or eliminate social service programs, it looks like part of a broader plan to go back in time--to an era when money was much more of a motivator for marriage, an era when women got married less because they wanted to and more because, financially, they had to in order to survive.

Look, I agree that some of the financial disincentives to marriage should be removed. And that poverty adds strain to marriages. But tackling this without tackling the more systemic causes of poverty seems shortsighted. You really want to support marriages for poor families, senator? Show your support for federally-funded day care.