For the first time since Fort Drum's expansion after the terrorist attack of 9/11, all of its three brigade combat teams are back home at the post. After multiple deployments in two wars spanning 11 years, the soldiers' needs for mental health services are unprecedented, and complicated. Fort Drum and the surrounding community are cooperating to respond to those needs.
Suicide rates and substance abuse remain problems throughout the military. Post-traumatic stress disorder and traumatic brain injury are the distinctive injuries of the Iraq and Afghanistan wars. At Fort Drum, as in the rest of the military, demand for services is outpacing their availability.
Colonel Mark Thompson is commander of medical services at Fort Drum. He says the post is struggling to fill the gap.
"Never has an all-volunteer force fought a 12-year war over a period of time," he said. "We continue to play catch-up because we're experiencing behavioral health care needs that we've never seen before, because we have a population that has not gone through what this population has gone through before."
It's all new to the north country, too. By design, the community provides for many of the health care needs of Fort Drum soldiers.
"The community health resources of the Watertown area, or the Fort Drum area – a rural area – has not experienced this need for behavioral health care ever," Thompson said. "And so as we ramp up, they're ramping up as well. And those type of processes don't just occur overnight."
Fort Drum coordinates with the civilian health care community through a nonprofit group called the Fort Drum Regional Health Planning Organization. That group has a program to recruit and retain medical providers, including mental health specialists. But those programs take time to work, as students enter the pipeline, gain education, and then go to work in the field.
Meanwhile, Fort Drum is redesigning the way it offers care. Teams of mental health care workers will be “embedded” with each brigade combat team – that's about 3,500 soldiers. That will put providers closer to where soldiers work and live.
"With that physical proximity becomes a real integration of the behavioral health providers into the unit itself," Thompson said. "And it makes it much easier for soldiers to go. They know the providers there, and they know that the providers there are part of the team, and therefore, they feel much more comfortable going there."
This approach started at Fort Carson and is now being implemented Army-wide. Thompson says it's worked. More soldiers are willing to seek help. Fort Drum should have the program fully in place by September 2013.
And the post is hiring dozens more mental health care providers. Dr. Todd Benham is Fort Drum's behavioral health care chief. He says the post has about 40 mental health care workers now. And the plan is to hire 30 or 40 more. In the meantime, Fort Drum has had to call on Army mental health care providers sent from off the post.
"That's really the goal, is to, you know, get us to the place where we're not having to rely on anything external necessarily, or having to call for assistance," Benham said.
Fort Drum is also working with local hospitals. Samaritan Medical Center in Watertown is expanding its inpatient psychiatric unit. River Hospital in Alexandria Bay is gearing up to offer intensive outpatient services.
And a $200,000 state grant will fund a two-year veteran peer-to-peer counseling program focused on post-traumatic stress disorder in Jefferson County. Peter Fazio is the director of the Jefferson County Veterans Service Agency.
"We're just getting it now, but this was probably something that should have been around for many, many years," Fazio said. "While PTSD is getting an awful lot of press now, it's been present for many, many years and has had many names in the past, so I think it's just great that finally there's some money dedicated for this particular program."
The program is envisioned as a gateway for veterans who are making their first effort to reach out for help, by helping to link them up with more intensive services. But it will also help veterans by simply connecting them to others who've been through similar experiences – whether that's combat, or making the transition back into the civilian world.
Roger Ambrose is the director of Jefferson County Community Services.
"The peer support specialist will know when someone – they'll be trained to know when someone needs services at a higher level than they are providing, which is really a supportive level, not a counseling or a treatment level. And they'll know where to send them to receive those services," Ambrose said.
In addition to the 19,000 soldiers at Fort Drum, there are about 10,500 veterans in Jefferson County. And Ambrose says it's not just the responsibility of Fort Drum or the Department of Veterans Affairs to take care of troubled soldiers and vets.
"Because they affect us all – whether it be in a family setting, where someone who comes back from the military is more stressed than he normally would be, less patient than he normally would be, and to the level where some people may even become violent," Ambrose said. "And we all have to be aware that that exists – we are aware that it exists – so this is an opportunity for us to try and resolve that for some people."
The county is waiting to hear back from local organizations who may be interested in running the peer support program. Organizers say it should be up and running before the end of the year.
Veterans interested in becoming volunteers with the PTSD peer support program can call Jefferson County Community Services at 785-3283.