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A sailor in crisis can’t get the mental health help they need when they need it, the top enlisted sailor told lawmakers this week. Tricare bureaucracy means they have to make an appointment with one doctor in order to get a referral to see another – a process that can add days or weeks to access counseling.

“That takes away the intent of the program, for us to have more accessible mental health care” said Master Chief Petty Officer of the Navy James Honea on Tuesday, testifying along with other senior enlisted advisers before the House Appropriations subcommittee on military construction, veterans affairs, and related agencies. Honea advocates following the same system available to Navy dependents, who have immediate access to telehealth counseling, without going first to their primary care doctor.

Honea’s testimony shows how hard the nationwide shortage of mental health providers has hit the military. Tricare has been expanding its telehealth services to offer more mental health care, but the two-step process to access counseling is still limiting the immediate access Honea says his people need.

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In testimony May 25, 2022, Seileen Mullen, acting assistant secretary of defense for health affairs, said defense officials were trying to lower the referral and approval barriers for tele-behavioral health.

Honea and other senior enlisted described other challenges with military health care. “We must improve our current health care systems,” said Sergeant Major of the Marine Corps Troy Black.

Access to adequate medical services and timely care is one of the top concerns Honea has heard in his visits to the fleet, during his six months in the job. In the Pacific Northwest, he said, “two naval hospitals have been downgraded, requiring sailors and families to drive an hour or more to seek military medicine and specialized care.”

Some Department of Defense civilians overseas are also facing challenges, unable to access military medical treatment facilities at all, Honea said. “Our DoD civilians are part of our total military family, and work directly alongside our military teams,” so require access to the same services.

As it stands, the Navy will begin losing civilian employees who are mission critical, he said, if they can’t get the help they need when they need it.

The lawmakers brought in the senior enlisted leaders to testify about quality of life of their troops, including issues like improving troop barracks and expanding access to childcare, as well as reviewing the current system of pay and compensation.

The leaders said the ongoing Quadrennial Review of Military Compensation — a complete review of military pay and compensation — would help drill into such issues, as well as how the Basic Allowance for Housing is calculated, and the problem of food insecurity many military families face. The Marine Corps’ Black said the current pay system provides no buffer to help troops deal with issues like inflation.

But Honea conceded that the Quadrennial isn’t going to be quick enough to solve many of the current problems.

He highlighted the San Diego area, where housing costs have increased by more than 26% in 2022, compared to 2021. Many junior enlisted families don’t make enough money to make ends meet and to have the amount of emergency savings to handle that kind of increase, while waiting for the Basic Allowance for Housing to catch up to offset those expenses, he said.

“Many found themselves well into their savings, and it’s understandable why many found themselves food insecure,” Honea said, which of course only exacerbates the very stress sailors can’t get immediate treatment for.

Karen has covered military families, quality of life and consumer issues for Military Times for more than 30 years, and is co-author of a chapter on media coverage of military families in the book “A Battle Plan for Supporting Military Families.” She previously worked for newspapers in Guam, Norfolk, Jacksonville, Fla., and Athens, Ga.