Secretary of Defense Robert Gates has announced that soldiers will no longer have to answer a question when seeking a security clearance about whether they have previously sought treatment for mental problems.  (Click here and here for more.)  The question discourages military personnel from seeking the mental help they need, because they don’t want to have to answer the question in the affirmative.  In the armed forces, a stigma attaches to anyone who has had treatment for mental and emotional problems, even if the problems relate to combat.  Secretary Gates says that mental injuries should be treated the same way physical injuries are treated.  Secretary Gates’ action was also prompted by increasing concern that soldiers returning from Iraq (particularly those who’ve been deployed multiple times) aren’t getting the kind of mental help they need.

Of course, the same stigma attaches to employees in almost any workplace.  You can’t ask questions about mental healthcare because of the Americans with Disabilities Act, but that doesn’t mean it’s easy for employees to discuss the subject for fear that it will be held against them in a way that healthcare for physical problems isn’t.  It’s one thing to suffer from diabetes.  It’s still quite another to suffer from depression.  That’s why some employees won’t even report a psychiatric visit to get reimbursement from a group health plan.  Someone in the company will know, and there’s too great a chance that he/she will tell someone else.

This stigma is reinforced by the way health insurance is allowed to treat mental problems vs. physical problems.  At present, employers and insurers are free to discriminate between physical and mental health problems (and most do) by setting higher co-payments or stricter limits on mental health benefits.  Earlier this year, the House of Representatives passed its version of the Paul Wellstone Health Care Act, which would go a long way toward bringing parity to the way physical and mental problems are covered by insurance.  The Senate had already passed the Act. 

Since there are differences between what the House and what the Senate passed, those differences will have to be resolved.  At present, the Act seems to be stuck, and the stigma continues.  Perhaps the action taken by Secretary Gates will encourage Congress to get moving, although until the November election, movement on anything will be hard to come by.