A top Defense Department health official said Tuesday that a law limiting the DoD's ability to ask questions about firearms ownership by service members hinders the physician-patient relationship and should be amended.
Questioned during a hearing by a Senate Appropriations defense panel on a 2013 law that prohibits DoD leaders, including commanders and health providers, from inquiring about or recording any information on private firearms owned by troops, Assistant Secretary of Defense for Health Affairs Dr. Lester Martinez-Lopez said the law, in terms of health care, is "not good for any of the two parties."
"As a physician, the relationship between my patients and I is ... sacred. We talk, and I expect him to be truthful with me so I can help him. Anything that interferes with that interferes with good medical care," Martinez-Lopez said.
A 2011 law prohibited the DoD from collecting any information on firearms ownership among service members who don't live on a military installation (members who live on base are required to register any privately owned guns with base officials).
Section 1057 of the 2013 National Defense Authorization Act further clarified the 2011 law, allowing military and civilian DoD health officials to ask about firearms ownership or possession, but only if they believe a service member is at risk for suicide or causing harm to others.
Otherwise, commanders and doctors can't ask about gun ownership, access and safety -- questions that are a key part of DoD and Department of Veterans Affairs' officials' efforts to promote safe storage of weapons as a strategy to reduce suicides.
Repealing the provision was among the more than 100 recommendations issued in a report last month by the DoD Suicide Prevention and Response Independent Review Committee to reduce suicides among service members and dependents.
Those recommendations included restricting the sales of firearms at base exchanges to anyone younger than 25, instituting waiting periods for gun and ammunition sales, improving promotion and assignment processes, and encouraging healthy habits, among others.
During the hearing, Sen. Chris Murphy, D-Conn., said he could not imagine that those who wrote the provision thought about the effect it might have on the doctor-patient relationship.
"I think [the provision] was due to some concerns about overreach, but ... as a rule, is it good medical practice for there to be gag orders on physicians as to what questions they can ask their patients?" Murphy asked.
Martinez-Lopez said the provision was bad for both physicians or patients.
"It's not good for either of the parties. If I don't know, I can't help you. If you cannot tell me, even worse," Martinez-Lopez said.
Between 2013 and 2021, 4,521 service members took their own lives, including active-duty, reserve and National Guard forces.
According to the committee report, firearms are used in about 66% of active-duty suicides, 78% of National Guard suicides, and 72% of reserve suicides.
During the hearing, the surgeons general of the Army, Air Force and Navy were questioned about mental health care availability and treatment within their respective services, with much of the focus on the Navy, which has seen a number of suicides among sailors assigned to ships undergoing renovations, and the Army, which saw a rash of suicides in Alaska last year.
Navy Surgeon General Rear Adm. Bruce Gillingham said the Navy has learned to send acute psychiatric response teams to units that experience trauma and also has established a new program, the Organizational Incident Operational Nexus, or ORION, that offers periodic check-ins and care following an incident.
The Navy also has instituted resilience training at boot camp that includes stress reduction techniques and meditation, according to Gillingham.
In Alaska specifically, the Army launched an all-out effort to address quality-of-life issues and increase the number of mental health personnel at local medical facilities, according to Army Surgeon General Lt. Gen. Scott Dingle.
"The commanding general has been, through a holistic approach, given resources and facilities," Dingle said.
DHA Director Lt. Gen. Telita Crosland told the panel that the DoD is doing everything it can to provide enough mental health providers and services to troops.
"There's not enough [providers] in our country to meet demand, to be honest, so we are doing our best with the contract, and we are taking a much more holistic approach by partnering with other teammates to help folks with their mental health," Crosland said.
-- Patricia Kime can be reached at Patricia.Kime@Military.com. Follow her on Twitter @patriciakime