U.S. Navy Bolsters Mental Health Services During Pandemic

As highlighted by the large-scale outbreak of COVID-19 on the USS Theodore Roosevelt aircraft carrier that started in late March, the U.S. Navy is not immune to the virus. Given the existing stresses of military service and the close quarters many naval personnel operate in, the COVID-19 pandemic might be a recipe for significant psychological burden.

“[S]o far, we have not seen a spike in demand for our mental health services,” said physician Capt. James Reeves, director for primary care and mental health at the Navy Bureau of Medicine and Surgery, during a virtual roundtable event in late May discussing how the COVID-19 crisis has impacted the Navy. “Inpatient hospital admissions have even diminished during this time.”

While it may still be some time before the mental health effects of COVID-19 emerge, Reeves said he is encouraged by these early trends.

The lack of a significant mental health spike is due in part to some broad protective factors, according to Reeves. “As a group, our personnel are all still employed and have access to health care,” he said. As many personnel are accustomed to long periods on vessels, they may also be more resilient to the effects of self-isolation. “Some individuals might even appreciate the necessity of spending more time at home with family,” he said.

Reeves also said he believes that the comprehensive mental health program developed by Navy Medicine known as No Wrong Door may be contributing to the positive early data. If Navy personnel experience mental health problems, they have a range of service options—from peer support to psychiatry specialists, Reeves said.

In addition to having psychiatrists available at the large Navy hospitals and medical centers, the Navy provides behavioral services (generally psychologists and/or social workers) at many of their smaller on-base primary care clinics. In the last decade, the Navy and other military branches have also started embedding mental health professionals with specific units such as submarine crews, aviators, or special forces. “Each of our units is unique in what it does and has its own culture,” Reeves said, noting that currently about one-third of mental health professionals in the Navy are embedded. “These embedded staff know how the units operate, they deploy with them, and can provide concierge-level care.”

Additionally, a referral program known as Military OneSource can help U.S. servicemembers to connect with non-military counselors if they feel more comfortable going to someone outside their base.

Supporting the long-term mental health of Navy personnel requires tending to stressors that were likely around before and will extend beyond the pandemic.

“This is especially concerning now since the extra time needed to manage a crisis situation prevents personnel from caring for their personal health,” said Joshua Morganstein, M.D., an associate professor of psychiatry at the Uniformed Services University of the Health Sciences (USUHS) and chair of APA’s Committee on the Psychiatric Dimensions of Disasters.

Fleet and Family Support Centers on bases and deployment resiliency counselors on ships offer counseling for issues including family illness, marriage problems, or sexual harassment. Additionally, Navy chaplains play a key role in supporting personnel, Reeves said. “People may think of chaplains purely as spiritual help, but they are trained in counseling on issues like grief and loss,” he said.

In response to COVID-19, the Navy has been quick to increase virtual mental health services. Reeves noted that most services being offered are telephone-based, though they are ramping up their video-conferencing abilities. Several Navy hospitals have also developed virtual programs to help both patients and caregivers during this crisis.

“We know that this pandemic is straining the health care system and creating excess operational stress on caregivers,” Reeves said. “We want our staff to be able to recognize stress symptoms early and ensure they can get the support needed.”

Morganstein added that the Center for the Study of Traumatic Stress at USUHS has created numerous resource sheets on how caregivers, patients, and families can mitigate the impact of the COVID-19 crisis. ■

The Center for the Study of Traumatic Stress pandemic resources are posted here.