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Key points
- The Secretary of the Navy wants veterans and those in active service to access mental health care when they need it.
- People in the military may need to shift their thinking from viewing help as unnecessary to viewing it as a show of strength.
- Peers can support peers directly if mental health is openly discussed.
Thomas Harker gets an email every time someone in the Navy or Marines dies by suicide. “I've seen too many people commit suicide,” says Harker, the Secretary of the Navy. “I want to do everything I can to help decrease the number of people committing suicide. I want them to have better access to mental health treatment.”
Harker is on a mission to provide better mental health care to those in active service and to veterans. “The number of people who commit suicide, it’s heartbreaking,” he says. “And a lot of that is due to mental health treatment that doesn't occur, or mental health challenges that aren't addressed, or conversations that don't happen.”
The Secretary has a three-part strategy: providing better access to care, empowering a culture of peer-to-peer support, and defeating the stigma around mental health care in the Navy and Marines.
The warrior ethos and the stigma of mental health
“Wherever you have a warrior ethos or a guardian ethos, people will say 'I can take it. I don't need help, let me keep taking it,’ until they can’t,” says Harker. “It’s the same in law enforcement, or fire rescue or health care. And we see far too many suicides, and far too few people getting the treatment they need.”
That’s why Harker believes it is critical to change the conversation and help his shipmates, as he refers to those who serve or have served in the Navy or the Marines. Instead of saying, “I’m strong, I don’t need help,” Harker wants his shipmates to recognize that the strong move is getting the help they need.
“It’s about early prevention. It’s like cancer, the sooner you catch it, the sooner you can correct it and get whatever it is you need, whether it's counseling, or prescription medications, or religious services,” says Harker, “Whatever it takes for each individual person to get the help they need.”
Yet for many people, the warrior ethos can make even getting help seem weak. Harker disagrees. “It's more powerful for you to acknowledge your weaknesses and work to improve them, or for you to acknowledge your need for something that you don't currently have, and then go get it,” says Harker. “If I've got a weakness in my leadership skills, I'm going to do everything I can to develop leadership techniques that will make me a better leader. Or if my knee is not working, I'm going to go get treatments to my knee back online so I can be fully functional.”
Harker sees profound courage in those who reach out for mental health care. “The strongest thing you can do is to address the things that are causing you pain and causing you to struggle, and that first phone call is scary. It's hard. It's much more difficult to do this so the true bravery is in admitting that you need help, and going to seek that help and pushing through all of the institutional barriers that may exist towards getting that help.”
The Secretary equates mental health care to military training. “It's just like how going through Boot Camp gives you a certain set of skills. It opens your body and opens your mind. You hone your emotions and get you to where you are fully capable of operating at your maximum potential,” says Harker
Facing trauma personally during service
Harker does not hesitate when he talks about his own experience with mental health. “I sought treatment for mental health three times in my life. Once when I was a kid my parents got divorce, another time during my own divorce. But the most critical time was after what I saw while I was on a ship in the Coast Guard.”
Over 20 years ago, a ferry boat with over a thousand people on board had capsized off the coast of Haiti. When Harker’s ship arrived 36 hours later, it was too late to rescue the passengers. “It was horrific. We were picking up mostly women and children. There was nothing we could do and they were the ones we were trained to protect,” says Harker. His voice cracks as he tells the story.
"It really hit the crew hard,” says Harker. “I was up on the bridge driving the ship, and we had other people who were down pulling people out of the water into the small boats. Then other people were pulling the bodies up onto the deck putting them in body bags.” The crew was exhausted. “After we took them back to Haiti and repatriated the bodies, all we wanted to do was go home. But the Coast Guard said, ‘No. You’re going to Guantanamo Bay and we're flying psychiatrists, psychologists, clergymen, and social workers to meet you.'”
In the aftermath of his experience, Harker had nightmares about being in situations where he was stuck and unable to fix anything. “I felt a sense of emptiness, a sense of inability to control my environment, which was tough,” says Harker. “And I think a lot of the people that were down in the water had much more significant challenges dealing with the trauma.”
Harker did not like the way he felt. “It was not the way I wanted to feel, as a military officer and a Coast Guard officer at the time. You want control of your environment. You want to be able to take the right action to fix things,” says Harker. “Picking up the bodies didn't feel good; we wanted to do search and rescue, not search and recovery. It goes against the core ethos of the service.”
But receiving mandated treatment from the Coast Guard made all the difference. “Being able to get that treatment was exactly what we needed. We talked about it, we worked through it. And for some people there was follow up treatment based on need,” says Harker. Now, more than 20 years later, Harker and those who served with him will sometimes talk about those events. “It’s healing even now,” he says.
Peer to peer support
That kind of peer support made a difference for Harker and his shipmates, and it’s one reason he wants to encourage the Navy and Marine Corps to do the same. “I want to help peers intervene with their peers, or their subordinates, or their seniors and say ‘Hey, how are you doing today? Do you need help? Are you thinking of hurting yourself? Let's get you to talk to somebody,” says Harker.
But what would he say to those who believe their own personal suffering is unimportant when what matters is the mission? “Everyone matters,” says Harker. “We’re shipmates. We're friends. We've worked together we've shared bread. We are all people who deserve to not suffer. No one deserves to suffer. And the path to treatment can be challenging, but it's also worth it once you come out the other side.”
Access to mental health care in the Navy and Marines
When it comes to access for mental health care, Harker says the Navy has been doing things like embedding mental health professionals with ships and with the Marines and adding more in clinics for a while now. “I’ve stepped on the accelerator and put more money into it this year and then also more money to next year's budget, across the five-year defense program,” he says.
People who need help in the Navy or Marines have a variety of options:
- The suicide prevention hotline
- Embedded mental health technicians for those on active duty in the Navy and Marines
- Fleet and Family Services
- Employee Assistance Program where people can get anonymous help that does not go through the medical system
- Medical practitioners
- Clergy
Be the best that you can be
But even with all of this, Secretary Harker is not ignoring the barriers that do exist. “Not everyone can fight with Tricare for three months like I had to to get services for my son.” He believes it has to get easier for veterans and those in active service to get help for themselves and their dependents.
For those who are still not sure whether to seek the mental health care they may need, Harker has these thoughts, “I can't lie and say it's going to be easy, I can't lie and say that it's not going to be a long journey. When you're dealing with trauma like this, it's going to take the same level of effort that you put into other things.
“But it's necessary and important for you to do that because if you don't get to the end of the journey, you're going to continue to suffer. And you're going to continue to cause pain for others around you, because you're not going to be the best that you can be,” says Harker. And in the end, that’s exactly what he wants for his shipmates: to be the best that they can be.
