stigma and barriers to care - Uniformed Services University of the ...

Day 1 Discussion 95
DR. SUTTON: It means so much to me and members of my team that each of
you would spend this kind of time and this kind of energy to figure this out. Because,
as the Secretary of Defense has said, we are truly in uncharted territory going into
year number nine of this conflict. What has been said here about needing to look
for novel ways to look for paradigms, ways of communicating with this generation,
is critical. Some wag once said, “Culture eats strategy for lunch any day.” I would
welcome anybody’s thoughts on how we can accelerate relevant cultural change that
fits this generation. Keep in mind, our troops today knew our country was at war
when they raised their hands and said, “Here I am. Send me.”
That was well before the economic downturn happened. They are a group who
do not think of themselves as sick. They prefer to think of themselves as injured.
They have been raised and trained to be part of a team. Perhaps that is why the Army
slogan “Army of One” was relatively short lived and has now been replaced with
“Army Strong.” They develop bonds of trust with their coaches. When that trust is
fractured, no good comes out of that. It is a wound that has to be dressed. We have
a bit of that going on right now in the three years following the wound that was
exposed and endures at Walter Reed.
So I need help from each of you here. How can we help dress that wound of
mistrust that still exists, not just between our providers and our public, our leaders
and our providers, but within each of us as citizens of this great nation and as
global citizens of this very small planet Someone once said that a wound inflicted
is a wound endured. We as a nation have sent our sons and daughters into harm’s
way. We have inflicted this wound and together, to heal, we must endure it together.
That is going to take time. That is going to take thinking. It is going to take bringing
together novel thoughts and novel ideas. It is going to take humility because, I can
assure you, not only do we not have all the right answers at this point, I am not sure
we have even asked all of the right questions. I would just ask us all to keep asking
the right questions, and above all, let us measure whatever success we achieve on
this journey through the eyes of our warriors and their loved ones, whom we are
so privileged to serve.
DR. BROWN: I returned with Wendi Cross and Doug Zatzick and perhaps
some others from a conference last week on dissemination and implementation.
The thing I would be interested in looking at is how we move from an information
production system, which includes things like clinical knowledge as well as some
research studies, to a knowledge implementation system where we can actually move
practice and policy.
DR. CROSS: I would be interested in having people talk a little bit about the
difference between the confluences of factors around help-seeking. We talk a great
deal about getting people to seek help but I guess I am wondering about the flip side.
If you ask somebody if you could help them, would they accept the help What is
the difference between being on each side of that relationship I am also interested
in credible messaging and how that might be helpful.
DR. ZATZICK: Disaster and terrorism, clear, simple, eloquent models, ideas
that will help me out because I do not know what to do. I have been working with
Chuck Engel on his STEPS-UP trial, trying to help him think about returning Central
Asian veterans. We need clear, simple, and eloquent ideas to lend these hardheaded
clinicians and to help other people implement trials.
DR. URSANO: The good news is that we have created a marvelous list. The bad
news is that we now all own it, and not just within this meeting. We will clearly only