Respect troops’ mental health: Defense contractor must answer on claims of limited care, requests to violate HIPAA

Every U.S. soldier who returns from a tour of duty in a combat zone – be it Afghanistan, Iraq or any other place – should have access to full mental health treatment.

Common conditions, such as post-traumatic stress disorder, should not be excepted from this treatment.

Session notes should not be sent to some unknown employee of a human resources firm.

And payment should not be withheld from those who fully treat soldiers while protecting the confidentiality of their records.

All these things should not even have to be explained – but apparently they do, because a contractor with the U.S. Department of Defense is doing things it should not do.

Those things were brought to light in a Missoulian news story published last Sunday. The article described the frustration of a Missoula therapist who is standing firm against indefensible dictates recently handed down by Ceridian, a company that describes itself as providing "Global Human Resources, Payroll, Benefits & Payment Solutions."

In this case, unfortunately, it is also providing problems.

Ceridian is under contract with the Defense Department to provide mental health services to U.S. soldiers. Earlier this year, Ceridian sent out a letter to all the mental health professionals with whom it maintains contracts – including licensed clinical counselors such as Missoula's David Stube.

This letter directs counselors to agree not to provide treatment for some of the most common conditions experienced by soldiers who have been in combat situations and their families: post-traumatic stress disorder, depression, addiction issues, and suicidal behavior. As Stube pointed out, the military encourages soldiers and their families to contact Ceridian-contracted counselors for treatment of these conditions. Counselor contracts specify that soldiers are entitled to 11 sessions.

"If you are a soldier or in a soldier's family, this means you can no longer be counseled for these conditions, even though all military websites refer all soldiers to Ceridian MilitaryOne Source counselors for these exact issues," Stube explained. "The websites neglect to tell the soldiers that the counselors have agreed to not treat PTSD, depression, addiction issues and problems with dangerous angry behavior."

That's cause enough for concern, but incredibly, the letter also included a form for counselors to sign that would waive client confidentiality.

"… if the counselor does not post their clinical notes after each session on the Ceridian website within three days after seeing the soldier, the counselor will not be paid," Stube said.

That's absolutely outrageous. To require counselors to send the private details of their treatment sessions – via email, no less – to some unknown, unnamed employee of a large company with offices located in several different countries, is directly counter to the right of privacy spelled out in the Health Insurance Portability and Accountability Act, commonly known as HIPAA.

Clearly, Ceridian has some explaining to do; however, so far it has provided only vague and exceedingly obtuse explanations. Of course, U.S. Sen. Jon Tester, D-Mont., has yet to receive any answer at all to the letter he sent to Department of Defense Secretary Robert Gates.

In that letter, Tester asked Gates to clarify the reasoning behind Ceridian's policy changes, which Tester went on to describe as "unreasonable and counterproductive."

Hopefully, the Defense Department is in the process of extracting specific answers from Ceridian. In the meantime, add the Missoulian's editorial board to the growing number of people who are asking how these changes can possibly be of benefit to our nation's soldiers – and demanding that Ceridian reverse them.

Every soldier who serves this country should feel secure in the knowledge that comprehensive, confidential psychological services will be available if they are needed. And any company that does anything to jeopardize that security should be made to answer for it.

EDITORIAL BOARD: Publisher Stacey Mueller, Editor Sherry Devlin, Opinion Editor Tyler Christensen, Sales and Marketing Director Jim McGowan