The Defense Health Board met in Tacoma earlier this week to discuss health concerns facing servicemembers, but the board members didn't stick to briefs and slideshows. The group also took the time to get information from actual Soldiers.

The board, which meets about four times a year, makes recommendations on health policy to the Secretary of Defense.

The group came to Hotel Murano on Aug. 9 for a regularly scheduled meeting, and took advantage of the time near Joint Base Lewis-McChord to meet with Soldiers and tour Madigan Army Medical Center the following day.

Part of the all-day conference included panel discussions with JBLM Soldiers focused on improving and destigmatizing behavioral health overseas and in garrison.

Suicide rates are up across the Army and Madigan Healthcare System had 92,919 behavioral health visits in the past year, a sharp increase from the year before.

"We've had this huge spike, and now what we're doing is we're tracking to see what that volume does," Madigan commander, Col. (Dr.) Dallas W. Homas, said in his presentation to the board.

Some of the increase is linked to troops redeploying, and Homas pointed out that a greater number of visits indicates that the stigma is beginning to disappear. However, the issue is as important as ever, and a top priority for Madigan and Western Region Medical Command.

A panel of five company commanders answered board members' questions about Soldiers' access to and comfort using behavioral health services downrange and the challenges they face as leaders.

Among these were issues with the Post-Deployment Health Reassessment. Several of the commanders said Soldiers will select the right answer over the real one just to get home more quickly. With no face-to-face interaction, the assessments are easily rubber stamped.

"I think it would be better if the providers took time to maybe ask them the questions," Capt. David Korman, 617th Engineer Company, 555th Engineer Brigade, said.

Board members were also interested in whether an officer looking forward to a full 20 years in the Army would be likely to seek treatment for behavioral health concerns. Studies have shown company grade officers have lingering problems with stigmatization.

Captain Rex Broderick, 565th Engineer Company, 555th Engineer Brigade, felt this was a legitimate concern.

"To me it shows not so much weakness but a chink in the armor that most leaders would not want to show to their Soldiers," he said.

In spite of ongoing issues, the commanders felt attitudes are showing improvement from a few years ago. A second panel of four Army physicians agreed, and pointed out that having health care professionals directly associated with units is a huge help in identifying and helping Soldiers who are having problems.

"One of the keys we have noted was having a provider that's actually integrated in the unit from the start," Capt. John Alvitre said.

Alvitre served in this capacity downrange, and found that monthly meetings with command team members allowed them to get a fuller idea of who was having trouble with what. Having the same doctor with the unit for extended periods of time also helps build trust.

"If you can do that, you can be there when the Soldiers need that," Maj. (Dr.) David Harper said.

Ultimately, hearing from Soldiers themselves added an extra dimension to the facts and statistics board members collect in briefings.

"You're actually putting faces on the issues we've been talking about," Defense Health Board Dr. Nancy W. Dickey said.