When sailors and their families commit to serve in the U.S. Navy, they are in a metaphoric trust fall. They expect the Navy to be there to catch them. In exchange for an arduous life of service, sailors can and should expect their pay, housing, and medical needs to be handled with care and efficiency. However, the policies that should provide for the care of sailors and their families are falling short—specifically when it comes to mental health services. A course correction is in order.
Sailors Are Our Top Priority
Words alone cannot build a high-functioning, resilient force. The mantra “sailors are our top priority” must be backed up with investment and visible effort. To that end, the Navy should streamline sailor access to mental health care.
Shipboard life and deployments disrupt how 21st-century sailors communicate and connect with others. Today’s sailors equate interpersonal “connectedness” with electronic “connectivity.” But their day-to-day jobs often involve being electronically cut off from their usual support networks. As a result, many sailors find themselves feeling detached and lonely. These feelings can be even more acute in the shipyard environment, where the Navy has recently struggled to maintain acceptable quality of life standards.
Feelings of detachment can be difficult to reconcile, especially for the newest and youngest sailors. According to Captain Tara Smith, a mental health officer for Naval Surface Forces Pacific Fleet in San Diego, “[for] a lot of our young people . . . The Navy’s a tough adjustment.” For some, this adjustment requires some level of mental or behavioral health care. The Navy’s increasing use of embarked psychologists, deployed resiliency counselors, and educators attests to this requirement. Unfortunately, there are not enough of these providers available. So, the Navy continues to struggle with providing mental health services to sailors in a timely manner.
Current policies are at least part of the problem. Active duty sailors who require non-emergency mental health care must be referred to a provider by their primary care manager (PCM). This process takes too long. It can take weeks just to get in with the PCM for initial screening. Even after receiving a referral, sailors often face long waits for appointments with overwhelmed mental health providers—sometimes up to five weeks.
Not acting to fix this problem is simply unacceptable. The consequences of not treating someone with an impaired mental state can be tragic. Death by suicide is a national crisis from which sailors are not immune. Multiple deaths aboard USS George Washington (CVN-73) and the Mid-Atlantic Regional Maintenance Center in 2022 illustrate the need for immediate action.
Sailors learn resiliency from their leaders and the peers who help share their burdens, and a support network that catches them when they feel like they are falling toward crisis. While establishing a community of trusted leaders and peers is important, a complete support network must include a reliable mental health care component. To that end, the Master Chief Petty Officer of the Navy James Honea recommends removing the PCM referral requirement for sailors and providing them with direct access to providers. This recommendation is in keeping with the same system now available to Navy dependents, who can immediately access telehealth counseling without a referral. An additional step would be to increase direct access by reimagining mental health clinics as walk-in “sick calls” where patients can be triaged appropriately for follow on care. The Navy must reexamine any push to consolidate mental and behavioral healthcare services as a means of gaining efficiency and cost savings. It must focus on getting providers faster access to their patients—even if it costs more and affects operating budgets.
Keeping faith with sailors is the solemn obligation of every Navy leader. In my 31 years as a Navy officer, I have never come across a leader who does not wholeheartedly agree with that statement. Allowing a sailor’s “trust fall” to become a “trust fail” does not happen through leadership indifference, but through organizational disfunction. The bill to regain sailor trust will cost more in money, time, and attention than the Navy has the wherewithal to measure. But it is a price that must be paid to catch and hold a sailor’s trust. The Navy must do better when it comes to mental health services.