Why does Big Navy’s mom have mental health care shortages, long waits?

As the United States grapples with a shortage of mental health providers at a time of growing need, the Navy is also struggling to fill such positions for the fleet, according to data provided by the Navy’s Bureau of Medicine and Surgery.

But while BUMED officials provided basic numbers to Navy Times last month, they did not respond to a request for an interview with management for a deeper look at the challenge of filling the shortage and the long wait times sailors report when seeking mental health help. which management encourages them to obtain.

As of last month, the Navy had not filled 132 of the 455 budgeted jobs for licensed civilian and contractor mental health providers, according to BUMED spokesman Ed Gulick.

Gulick said those numbers do not reflect the Department of Defense-funded health care providers to which Sailors may be referred, but that BUMED is working to shore up its own deficiencies through “recruitment initiatives, retention and position classification updates.” .

On the active duty side, the Navy is 10 members short of its 467 approved enlistments for psychiatrists, clinical psychologists, licensed clinical social workers and psychiatric nurse practitioners, according to Gulick.

These positions are based in military hospitals and clinics and are also included in deployed units.

“In light of the national shortage of mental health providers, Navy Medicine continues to maximize direct enlistments, graduate education, reassignment and special payments to improve recruitment and retention,” Gulick said.

Gulick did not respond to follow-up emails seeking additional information.

The Navy’s shortage of psychiatric providers and long wait times were shown in person by Chief Petty Officer Russell Smith during his leaked one-on-one conversation with the crew of the aircraft carrier George Washington in April.

Smith spoke candidly about being told last year he would have to wait six weeks to see a Navy provider, a line he avoided by seeking private care “because I could afford it,” and how the nation generally suffers from a shortage of mental health providers.

A March article in the Psychiatric Times reiterated that point, noting that while more adults in the United States are reporting symptoms of anxiety and depression since 2020, the supply of providers has lagged for years.

In 2013, it was estimated that the country would have a shortage of more than 6,000 psychiatrists by 2025. That estimate has now reached 7,500, according to the report.

“There just aren’t many,” Smith said of the much-needed psychiatrists.

A November 2020 American Psychological Association survey found that three-quarters of respondents reported seeing more patients with anxiety disorders than before the pandemic, while 60 percent of respondents said they were seeing more patients with depressive disorders.

Nearly a third said they were seeing more patients overall.

Despite the need, Smith noted in April that the Navy cannot mass-produce specialists for these vital positions.

“You can’t just snap your fingers and become a psychiatrist,” Smith said. “It takes years, decades of school and training and practice and internship and everything else that gets you to this point.”

Smith also suggested that some newly minted psychiatrists may not see the Navy as their best career option.

“When you’re really in debt and you owe a lot because that’s what it takes to become a psychiatrist … the kind of debt you have doesn’t necessarily get you into the Navy,” he said. “Do you want to earn that money and pay back your student loans in about five to 10 years? Or would you like to owe this for the rest of your life and maybe… come into the Navy as a lieutenant?”

Defense officials will begin a pilot program this fall to test a behavioral health model for personnel that matches “supply with demand,” Celine Mullen, acting assistant secretary of defense for health affairs, told lawmakers during a hearing on May 25.

“We will also significantly improve our telebehavioral health, including 63,500 visits this year,” she told the House Defense Subcommittee. “We’re also trying to lower the barriers to being referred and approved for Tricare. While there are shortages in certain areas, we are addressing them and understand that this will not be an easy or quick fix.”

Navy Surgeon General Rear Adm. Bruce Gillingham told lawmakers that the Navy is prioritizing mental health support aboard shipboards with onboard mental health providers.

About 36% of active mental health providers and 30% of behavioral health technicians are assigned to these billets.

Those providers are embedded on ships and submarines, with Marine units and training commands, according to a copy of his written testimony before a May 25 House hearing.

The Navy has seen significant increases in the use of virtual mental health services as well as primary care, he said. In fiscal year 2021, nearly 20 percent of mental health screenings for Sailors and Marines were performed virtually.

Gillingham noted that the Navy, like the other services, also focuses on prevention.

“Starting in boot camp, all of our recruits are taught stress reduction techniques and meditation,” he told lawmakers. The service also teaches leaders how to identify people at risk “so we can get them to care.”

Jeff is a senior staff reporter for Military Times focusing on the Navy. He has covered Iraq and Afghanistan extensively and was most recently a reporter for the Chicago Tribune. He welcomes any and all advice at [email protected]

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