Mary Jo Larson, a senior scientist at the Heller School, researches effective types of mental health care and the related financial components, and was one of committee members who published a new report initiated by the U.S. Department of Defense and the Institute of Medicine, titled “Substance Use Disorders in the U.S. Armed Forces.”
“I’ve always been interested in what makes people tick,” Larson said. Larson earned her undergraduate degree in psychology and a Masters in Public Administration from Harvard’s Kennedy School of Government. She admits she always wanted to conduct research related to social justice, initially in welfare policy. But throughout her career she continued to be more drawn to mental health policy. “And mental health policy involves social justice, too,” she said.
Substance abuse in the armed services has been a persistent concern for several years, but recently the problem has worsened. Between 1998 and 2008, the latest year for which data is available, monthly binge drinking increased by 12 percent and prescription drug misuse increased by 9 percent, according to the report. Concerned with the increasing number of suicides and overdoses related to the surge in substance abuse, Congress asked the Department of Defense to explore the problem. The DoD requested the Institute of Medicine form a committee charged with researching substance abuse within the United States military. Because of Larson’s expertise in the mental health field, coupled with her insights into military, she was chosen to be apart of the 14 member committee, which has now completed the report.
Relying on the committee members’ significant background and familiarity with the functions and intricacies of the military system, they were able to dive in immediately. The team hoped to identify the causes of the recent surge in substance abuse and suggest strategies to remedy the problem. They researched together for 15 months, investigating the rudimentary question: What is the military doing to prevent the abuse of drugs and alcohol?
The conclusion: not much. While military commanders are not tolerant of substance abuse, they are also not taking the necessary public health approach, the report argued. As Larson explained, in order to prevent substance abuse, early intervention is key. Identifying early warning signs and providing early treatment would alleviate the problem considerably. Instead, substance abuse is treated as a disciplinary issue, akin to bad behavior. In actuality, it is a “condition,” Larson said, with “different risk factors and environmental factors. If you ignore the problem … you can’t just wish it away.”
Alcohol abuse has become part of military culture, infused with machismo and providing an avenue to cope with stress, the report found. Drinking is a normalized behavior for soldiers in their “work hard, play hard” environment. However, the dangers of this component of military culture are often unrealized.
“Commanders need to change the drinking environment, to identify personnel with elevated risk, to educated personnel about how heavy drinking impairs adjustment after combat deployments, and to offer confidential, medically-based interventions,” Larson said.
Although forming policy changes from research is difficult, committee members are optimistic and motivated to see improvement. Larson said the committee’s goal now is to disseminate their research findings and advocate for new grants to help evaluate their conclusions “so the policy makers inside can say ‘here’s the evidence.”
