healthcare, Military, rants

Repost: EFMP… There’s nothing “exceptional” about it.

I am rerunning this post that appeared on my original blog, back on March 10, 2013. I am no longer an “Army wife”, since Bill retired in 2014. However, we know the lifestyle and this post got tons of hits… plus, it came up last night as we were remembering how I was FORCED to join EFMP because I had taken antidepressants. And then, once we got to Germany after I had dutifully enrolled in EFMP, Bill got a shitty email from some uppity guy at Walter Reed Army Medical Center in Washington, DC, wanting to be “apprised” of my “condition”.

We were laughing about it, though, because unlike “Big Army”, the National Guard didn’t give a fuck about EFMP. They cut Bill’s orders for Germany before I ever visited the medical people in DC, so I probably could have skipped the whole thing and totally gotten away with it. Of course, that was in 2007, and things have probably changed.

Anyway… Bill was funny last night as we were remembering that time because he said, as we remembered the email, “No, you don’t. We’re already here. Fuck off.” He’s obviously benefiting from my “charms”, which have rubbed off on him. To clarify, no… that’s not what he actually said. Bill is very good at politely telling people to fuck off. He basically told the guy to leave us alone and they complied. But thirteen years later, he might say it. That makes me proud. So here’s the post from 2013. Maybe it will be interesting/helpful to someone while I wait for fresh inspiration.

Back in 2007, my husband was deployed to Iraq.  We were also planning to move to Germany.  Because Germany is not in the United States, I had to do some things to prepare for the move.  One of the things I had to do was get a physical.  I was really dreading having to do this for a lot of reasons.  First off, I’m not a big fan of going to the doctor’s office.  I especially hate going to military doctor’s offices.  It’s a pain in the ass to set up the appointment.  Military medical providers tend to talk to their patients as if they are either children or in the military, even if they are civilians.  I also had a very traumatic incident with a military provider in the 1990s that continues to haunt me today.

Anyway, I had to get this physical and then I had to be screened for the Exceptional Family Member Program, a supposed benefit for military families.  Basically, what EFMP does is allow a servicemember’s command to consider the medical and educational needs of a family member before moving their “sponsor”.  I have already ranted about the term “dependent” to describe spouses.  My husband is considered my sponsor.  How’s that for demeaning?

So I got a friend to help me set up my appointments.  I saw a physician’s assistant who turned out to be really kind and patient with me, especially after I told her about my first and last disastrous attempt to get a pap smear when I was 22 years old.  She thought I had high blood pressure, but it turned out my high readings were caused by white coat hypertension.  That was proven by 24 hour ambulatory blood pressure monitoring, which involved wearing a sphygmomanometer for 24 hours.  As soon as I stepped out of the military hospital, my blood pressure readings dropped to normal.

Finally, I arranged to be screened for the EFMP, which I had been told involved having a doctor look at my records and determining whether or not I had any conditions that warranted special consideration as to where my husband could be assigned.  From 1998 until 2004, I took antidepressants and went to therapy for depression and anxiety.  The worst of my issues were from 1998-99.  I chose to stay on antidepressants while I was in grad school mainly because I didn’t want to feel shitty while I was dealing with such a stressful time of my life.  At the time, I had no idea I would ever marry a military man.  I could have gotten off the antidepressants earlier than 2004.  I got off them because I dropped civilian health insurance and was hoping I might get pregnant.  I got off the drugs with no incident and didn’t even miss them, except they helped me keep my weight down.

What I didn’t know was that my time on antidepressants would come back to haunt me.  The EFMP required that I submit ALL of my medical records for the past five years.  Those records included my therapist’s notes about my depression, which were very personal.  I suppose in retrospect, I could have removed the records from before 2002.  I didn’t think to do that.  I showed up for the EFMP screening and was left sitting in the waiting room in the pediatrics department of the local military hospital while the doctor looked at my paperwork.  She finally came out and told me I needed to be in EFMP because I’d had depression and it might be risky to send me to Germany.  She listed the reasons she thought I was at risk.  I might have trouble adjusting to culture shock.  I might get depressed if my husband got deployed (even though he was already deployed when I met with this woman).  I might have problems with the fact that Germany isn’t as sunny as the USA is. 

Our conversation was laughable.  Here was this young doctor in a military uniform telling me that it was a good thing we were bound for Germany, since if we were going to Hawaii, I probably wouldn’t get to go.  She claimed there weren’t enough therapists in Hawaii.  I looked at her dumbfounded and said, “You know, I have an MSW.  The Army could hire me.”  Moreover, this move to Germany would be my third overseas.  I had already survived clinical depression while in Armenia.  I knew Germany would be a piece of cake for me.  But that didn’t matter… my thoughts about my own stability and personal desire to stay out of EFMP meant nothing.  It was fruitless to argue with the doctor, who was just covering her own ass.  She said I could try to disenroll in 2009 and maybe the EFMP would grant my request.

She then told me that if I didn’t comply, my husband could get kicked out of the Army.  And she said he wouldn’t get his orders if I didn’t do what she said.  Her face registered shock when I pulled out a set of orders, already listing me as having command sponsorship.  Apparently, the National Guard couldn’t care less whether or not I have depression.  She spluttered, “You’re not supposed to have those yet!”

It was truly ridiculous.  But because my husband was in Iraq and I didn’t want to cause issues, I complied with the demand that I join EFMP.  I filed the paperwork and we went to Germany.  Some months later, my husband got a nastygram from the very pushy EFMP coordinator in DC, demanding my status.  They needed to be “apprised of my condition”.  My husband sent him an email letting him know that I had no desire to be in the EFMP and didn’t need it.  We never heard another word about it and I got through my time in Germany without incident.

The military is pretty intolerant of head cases… even though if you read my articles about nutty Army folks, you know that the military is rife with them.  The official policy requires that servicemembers who are depressed seek help for their issues.  The unofficial policy is that if you or a family member see a therapist or take psychotropic drugs, your career will probably suffer.  You might lose your security clearance or be stuck in some shitty assignment indefinitely or get sent somewhere you’d rather not be.  I sought therapy for my depression and anxiety when I really needed to.  I’m glad I did it; it probably saved my life.  I had no way of knowing that making the very mature decision to seek help would end up in a ridiculous conversation with an intractable doctor who didn’t know me from Adam and was basing her medical opinions of me on three year old notes from other providers.

I understand why EFMP screening is mandatory for people going out of the country.  I just wish the process involved more subjectivity and people using common sense.  I wish that competent adults were treated more like stakeholders in their own healthcare and given more of a partnership in the process, rather than given the bullshit line about how the screening is for their own good.  The screening is about covering asses, saving money, and controlling people.  Moreover, you can get around the EFMP.  A lot depends on who you are and who you know.  I personally know someone who had her paperwork changed so the EFMP restrictions would be lifted and she could take her kids to Germany.  In her case, it worked out fine.  I know of other people who were not allowed to go abroad because of EFMP and they could not get their EFMP status changed. 

I don’t mean to say that EFMP is not a valuable program for those who need it.  There are families who have kids with special needs that need that special consideration.  It’s not good to go to a new duty station and find there are no suitable facilities to handle someone’s medical or educational issues.  That tends to lead to the family having to be sent elsewhere, which costs a lot of taxpayer money and causes lost productivity.  It’s also a pain in the ass for the family. 

However, the EFMP requirement is not good when it’s forced on a family, particularly when the “exceptional member” is a competent adult.  People know that EFMP can cause plum assignments to get cancelled.  Supposedly, this is not true… the military will tell people that EFMP won’t mess up a person’s career.  But in reality, being limited in where you can go can mess up your (or your sponsor’s) career.  Because of that, some people won’t get help for depression if they need it.  I mean, it’s hard enough to get help for depression because there’s so much stigma.  If it might also mean you can’t go to Germany with your husband, you might also hold off on calling for help.  And that can lead to tragic consequences.

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