Provider shortages are making implementation of the Brandon Act harder
The Pentagon has begun to implementing the Brandon Act, named after a sailor who died by suicide in 2018. Designed to address the military's elevated suicide risk, advocates worry it’s only part of the solution.
The last several years haves been exhausting for the parents of Brandon Caserta, who died by suicide at Naval Air Station Norfolk.
“He just helped people, almost from birth. He loved life. He loved people. He loved to help people,” said Teri Caserta, Brandon’s mother.
He left texts saying he had been bullied and harassed by his command. The sailor’s final notes say he wanted to help others in a similar situation, so his father Patrick says the family pushed for the law, which makes it easier for sailors to ask for help, even when their command is reluctant.
“If you invoke the Brandon Act, you get to go attend to whatever your problem is immediately, and the command needs to help you with it. So if you don't have an appointment or can't get one, they need to get you one and ensure that you're going,” Patrick Caserta said.
Congress passed the law in 2021. Caserta’s parents are frustrated that the Pentagon is just now implementing the new rules across all services. Each branch has a higher suicide rate than the general public.
The Brandon Act was officially rolled out May 5. The services have 45 days to create the policies for implementing the new law for all active duty troops. The law will then be extended to reserve and guard troops after another 45 day window.
The Defense Health Agency will train commanders on how to refer troops to mental health and promote the policy among service members. The idea to lessen the overall stigma of seeking treatment.
"Everyone wants a mental health professional"
Though the law spells out that commands are responsible for getting sailors help quickly, that doesn’t mean help is always available.The Navy told Congress last May that half its Deployed Resiliency Counselor positions were unfilled.
All of the services are struggling to find mental health providers, says Fr. William Waff, who runs the Military Chaplains Association.
Waff is a retired army major general. He worked as a hospital chaplain before he retired.
“Everybody wants a mental health professional and the number one job that the VA is recruiting for are mental health professionals and the branches of the military are doing the exact same thing,” Waff said.
So the services are filling the gap with chaplains, who are used to playing a spiritual and wellness role. Over the years they have been given more mental health training, but not enough to be licensed in mental health. Their job is to mainly alert medical staff when they notice a change in behavior among a soldier or crew member, he says.
“You will not be a therapist. You will not be a counselor,” Waff said. “Basically, you’re providing an awareness that there are some things that would be indicators for a referral to a mental health specialist.”
Even finding chaplains is tough. The Air Force wants more chaplins so they can deploy forward with their units. The Navy estimates it will need an extra 70 to 90 chaplains to fulfill its plan to put chaplains on every destroyer, Waff said.
Finding care is a challenge outside military network too
Finding care can be difficult even when service members pursue mental health care outside the military.
“There's to me nothing more rewarding than working with active duty,” said Greg Lemich, who runs the only private mental health practice in Norfolk dedicated to active duty clients.
He said private providers often have a full client list and are put off by the paperwork associated with TriCare, the military’s insurance. Clinicians in the private sector are often unfamiliar with how the military works.
His office sees an influx of new clients whenever an aircraft carrier arrives in Norfolk. They’re unfamiliar with the particular stressors of military life, and that doesn’t include just combat-related injuries.
“Military sexual trauma is unfortunately something that we see quite a bit. People who are on board a ship and somebody who they know commits suicide is something which can be very devastating,” he said.
The root cause of suicides is elusive. Around Norfolk, nine sailors died in a little over a year when they were assigned to shore duty or their vessels were in the shipyard. Cmdr. Michael Siedsma is captain of the submarine Massachusetts, which is under construction at Newport News. He acknowledges the challenge for the crew.
“It's certainly a big stressor for them. If you sign up for the Navy to go to sea and see the world and visit foreign ports and that foreign port is Newport News, Virginia, that maybe not what you would count on. It can be tough for some of those folks,” Siedema said.
His philosophy is to engage with sailors and keep the crew busy and motivated. He said the Navy has improved living conditions at shipyards in recent months.