Sunday, March 10, 2013

EFMP... There's nothing "exceptional" about it.

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.

40 comments:

  1. i know this is super old but it popped up in my google search about efmp and i can only agree. getting help with my anxiety disorder through the army was the worst decision i've ever made. i'm a german national and married to an american soldier. right now, efmp is preventing us from moving to another german post because they don't have any mental health providers (a blantant lie btw). so now his orders are gonna get changed to go back to the states in aproximately 2 months time, which is not enough time to get my visa in order. i'll be sitting in germany, homeless, carless, with no money and an anxiety disorder and depression that will go untreated because the post we are on is closing down for good and i don't have german health insurance anymore. the people responsible do not care in the least and call it a compassionate reassignment, which leaves me wondering who they're compassionate for, certainly not my family because they're literally ripping us apart.

    ReplyDelete
    Replies
    1. oh and i have tried to get out of efmp, which the coordinator ENSURED me i could once my medication can be handed over to primary care... and guess what... they won't let me. no reason given.

      Delete
    2. Oh Val, I'm so sorry. I've often wondered what happens to non-American spouses of people in the military. I guess your case is an example of that. How ridiculous that you can't be reassigned in your own country of origin! I'm sure you are more than able to find the help you need locally without help from the military, other than paying for services.

      I'm trying to think of who you might go to for help with this. There has to be someone in a higher position who could fix this somehow. You must be horrified and super frustrated right now.

      Delete
    3. thank you for answering and yes, both horrified and frustrated. everyone up to my husbands sergeant major is involved, my psychiatrist and therapist both wrote memorandums stating that my condition is mild enough to be handed over to primary care but the efmp coordinator won't budge. it's a maze you can't get out of, they keep sending us back and forth but no one wants to help. it makes me regret ever seeking help in the first place. i even offered to get out of mental health completely if that keeps us together but it's no use. the only thing i can do now is warn other people that this program can very much entrap and immobilize you and prevent you from being with your spouse for god knows how long.. every doctor i talk to is frustrated by how stubborn they are. it's pretty much all up to the coordinator and no one can do anything about it.

      Delete
    4. The EFMP coordinator definitely works for someone. Have you tried finding out who that person is and contacting them? If there's one thing I've learned through years of military life, it's that there is a chain of command and everybody works for somebody. Your situation doesn't make any sense.

      Delete
  2. haha i get that alot and i agree, it makes no sense whatsoever. we've gone all the way to the top. my guess is that they don't want to be bothered with it because the whole post is moving and they're busy. and i'd even understand that if it was something small or i'm just a naggy spouse, but this is somewhat lifechanging. i just climbed out of a very deep whole with the help of my therapist and i'm afraid i'll fall even deeper this time, without any kind of support from my husband or even so much as just my medication which will eventually run out. it feels like they see it all just as a statistic and do not care about the people behind it, which i kinda thought this program was all about... you know, helping people...

    ReplyDelete
  3. Replies
    1. Well, as I wrote in my post, a lot of that is lip service and people trying to cover their own asses. What I meant when I suggested going up the line of command is perhaps going off the post and contacting someone who is not involved with where you are. I see you are posting from Bavaria and I'm not familiar with which installation you're on. Someone had to make the decision to hire the person who is not helping you out, know what I mean?

      In the meantime, do you have family or friends you could turn to for assistance?

      Delete
    2. i'm in schweinfurt right now and we were denied in vilseck because of my efmp. the colonel in my husbands company is in the process of talking to the colonel in vilseck that is responsible for the efmp there but i highly doubt that they will change their mind. i feel so helpless as a civilian in this whole thing.. although it is about my condition i have absolutely no say in whats happening in my life right now. they won't even give me an appointment for a re-evaluation. i talked to the coordinator on the phone for 2 minutes and she said "yea no can't help you sorry bye"... so it's not enough that they're messing up my life, they have to be rude about it as well lol... no family worth mentioning really, my 80 year old grandma is still around but i'm afraid she wouldn't be much help even if she wanted to. it's at least nice to talk to someone that has been through a similar situation though so thanks for that =)

      Delete
    3. I truly do understand your frustration. I was pretty pissed off when I went through this same situation, although in my case it turned out to be a non-issue since we already had orders anyway and nobody in Stuttgart seemed to care about my EFMP status. I seriously never heard a word about it once we left the States, except for that one EFMP coordinator in DC who was a real hard-ass.

      Delete
    4. it really seems extremely uncoordinated. i'm happy it worked out for you in the end, i'm just gonna have to keep my hopes up that some miracle will pull us out of this weird situation.

      Delete
    5. Right. A lot seems to be based on who you are and who you know, which is really not fair. The only other thing I can think of is complaining to the Inspector General, but I've never taken that step and it could be risky. You could also file an ICE complaint, though that would probably go nowhere.

      Have you ever visited Military.com? I wouldn't normally suggest their message boards because they are over moderated by crusty military wives. There are some people there who might be able to give you more advice than I can, though. Some of those people have been dealing with military bullshit for many years. It might be worth a shot asking there if anyone has a suggestion for what you can do about this. If you go on their Web site, find the tab that says "Community" and then look for the message boards for military spouses.

      I kind of wonder if there's no one at a regional medical command who doesn't oversee this stuff.

      Delete
    6. isn't it always somewhat based on that? lol. we've already talked to ig, he said he could investigate but not promise that anything will come of it. not worth the risk i think. i'll try the message board, thanks for the tip =)

      Delete
    7. Good luck. Hopefully you'll run into someone helpful who can give you some tips on how to unfuck this situation.

      Delete
  4. Sorry i know this is old but i have my physical tomorrow to see if i need efmp for my asthma...im terrified of doctors especially needles....do they take.your blood or anything?? We are staying stateside...

    ReplyDelete
    Replies
    1. It sounds like you're going to get a regular physical rather than an EFMP screening. They may take blood or they may not. An EFMP screening doesn't involve any tests or procedures; it's just a doctor looking at your records.

      Delete
  5. Hey, sorry I know this is old, but I cannot for the life of me find out how to make an EFMP appointment, or who to call, or anything. I'm moving to Germany with my husband so I have to get this done and I heard it can take forever so I'm hoping to make an appointment ASAP! I also have mild asthma, do you think that will effect my eligibility to move to germany? Oh also, I live in NY and my husband is in the Army. My friend is an airforce wife and told me she had a different process.

    ReplyDelete
    Replies
    1. Hi Ecco. Do you live near a military installation? I think your best bet is to call the EFMP coordinator at the nearest installation and explain your problem or call the coordinator at the installation where your husband is based. Another good source of information is the Military.com spouses message board. They have entire threads on EFMP screenings there. I was screened in 2007 at Fort Belvoir. We lived on post, so it was a simple matter to go to the military hospital and arrange for the screening. Most military medical facilities have an EFMP office where you can find out what the current procedures are. My advice is to call or visit them.

      I have mild asthma and it wasn't a problem for me to go to Germany. The doctor who spoke to me was more concerned about my having taken antidepressants and had therapy years ago.

      Delete
  6. I know this thread is old, but I'm having problems with the EFMP office stating I have "neurotic depression" which I have NEVER been diagnosed with, and stating that because I get a BI YEARLY simple thyroid blood test that I need to be enrolled. its absolutely ridiculous that I am required to be in this program that has been nothing but a HUGE headache. we are also trying to go to Germany.

    ReplyDelete
    Replies
    1. I'm sorry for your troubles. My husband retired last year and we moved back to Germany... Same city. The medical care here is excellent. Unfortunately, I think EFMP tends to be very subjective about things. You may have to be very assertive to get what you need.

      Delete
    2. I believe this program was meant to do good but it has turned into power and control. Never piss off the EFMP program because they will make your life miserable because they can!

      Delete
  7. Hi we are airforce and have orders to Germany. I was flagged because my efmp in the army to go to Germany. I am bipolar with anxiety. I have been on steady medication for years. I am under control with no real issues now that I'm regulated. I'm wondering what my chances are of being flagged again

    ReplyDelete
    Replies
    1. I really don't know. I think it depends on a lot of factors. If you're headed to Ramstein, I would guess you might have better luck because it's near Landstuhl.

      Delete
    2. Hi Tobias ...similar situation here...sent you a message.My husband is in AF and we are hoping to get overseas. Wondering if my past will prevent that. I sent you a message via Google+ thanks.

      Delete
  8. I am trying to move my family to the Kansas City area, and I am having the same issues! My 6 year-old had speech therapy when he was 2 because he had fluid in his ears and the doctor thought it would help. Once I proved he no longer needed the service (and hasn't for 4 years), they put him back in EFMP for seeing a cardiologist! We did not ask to be enrolled, but yet they have enrolled both children. I asked to disenroll us, but they will not! It's so frustrating. If moving isn't stressful enough, EFMP makes it much, much more stressful. The program has grown too big, and it needs to be audited. My husband is staying in the area, and we are actually considering having the boys stay with him because I cannot get my orders. I wish someone would do something about this broken program! Argh!

    ReplyDelete
    Replies
    1. Wow, I'm sorry, Alexis. In many ways, EFMP makes it so much harder and more stressful to deal with military life. Seems like they should be able to find services for your kids if they are actually needed. Besides, that should be up to you, anyway!

      Delete
  9. Oh and I'm trying to bypass it all by unenrolling but they don't like that idea, even though I don't meet any of the requirements listed in the regulations. (Not mental health related, not life threatening and since the clinic hasn't been following this since I got here I obviously am ok with being seen once a year or less for it). But noooo

    ReplyDelete
  10. Oh my goodness I'm going through issues with EFMP right now, similar issues BUT we actually got approved for Germany and SHOULD NOT HAVE. We got here and services aren't available that we need, or the doctor's qualifications are not as good as those we saw in the states or they don't like to Rx the medication I'm on (nothing crazy any doc in the states can Rx it). NOW I'm having headaches going HOME. Since I have been to the clinic here all of twice because they don't actually do anything for me they don't have records for me and want me to go through unnecessary testing and procedures TO GO BACK TO THE US. And my husband can't request his next assignment until everything is updated-which means we will probably loose the slot he is hoping to get by the time it is all done. All of this AFTER having to deal with 2+ years (it will be 3 when we leave) of not having the services we need even though it was on our paperwork in the first place. So yeah, actually being enrolled doesn't really help.

    ReplyDelete
  11. I am currently going through screening with EFMP and having issues although any counseling or meds for minor depression was requested years ago. I am feeling so defeated & humilitaed for having to have myself evaluated for going to marital counseling voulentary and have these things resurfaced by complete strangers. The kicker is that the nurse doing my screening tries to talk to me about how okay it is to be alone and if she can, then I can...I haven't been to my marriage counselor in 4 months...my marriage has gotten way better and here she is guaranteeing and recommending me to leave my spouse.I am currently contacting her supervisor, as is my marital counselor who is a psychologist and together we are fighting efmp. I'm sure her heart is in a good place, however it is NOT her job to have any personal advice in about my life.

    ReplyDelete
  12. The EFMP lady at Rucker is by far the worst EFMP nurse! She denies anyone with any kind of medical condition, even asthma!

    ReplyDelete
  13. I was doing my research on EFMP after signing in to my first duty station and marked yes for having EFM couple days ago. My wife was suffering depression ever since I went to basic training and she just started her antidepressants Rx'd by her family doctor. She's not found another family doctor yet. (BTW, we're trying to stay on TRICARE Standard instead of Prime so that we don't have to deal with military hospital if it's possible at all) After reading both the post and comments, I was horrified by the fact EFMP can be just another military mess. Now I hesitate to even start seeking help at all for my wife in military area. I'm not sure if I'm doing the right thing. Career wise, I just want to do as many years as I can, so that we can have Tricare to cover the cost of her treatment. Otherwise, I don't care where I'm getting assigned.

    ReplyDelete
  14. Hi,
    I am trying to apply for command sponsor for korea. I recently gave birth and suffer postpartum depression. My military doc prescribed antidepressant for me. I stopped after 3 weeks and I am feeling back to normal now. How likely will I be put in EFMP during my screening. If EFMP make me enroll, how can I fight for it. I feel totally normal now. It was just a temporary thing due to postpartum. Please help me.

    ReplyDelete
    Replies
    1. I really couldn't tell you. A lot seems to depend on who's doing the screening. Also, whether or not EFMP would prevent you from going to Korea would depend on decisions made by local authorities in the receiving installation. If you're not on antidepressants now, I would imagine that would work in your favor, although they might be concerned about you if you plan to get pregnant again.

      My best advice is to talk to the person screening you about your concerns. Of course, you may end up with a real "winner" like I did. :(

      Delete
    2. Hi knotty,
      My doc on base said most likely I'll have to enroll efmp due to the fact that I was recommended for couseling. However, I choose not to receive counseling. I'm so lost in this. Would a doctor note stating I'm in stable condition make a different in my command sponsor.

      Delete
    3. My advice is not to mention it to the counselor unless it is documented in your records that the counseling was recommended. If it is documented, you may be referred, whether you have a doctor's note or not. It depends on the screener. I am no expert, though, especially since my experience was in 2007.

      Delete
  15. call your local congressmen, explain it all. its election time after all.

    ReplyDelete
  16. How can I get out of EFMP? I had a minor bout of depression after my son was born in 2015, and a few years before I had some depression and anxiety problems. Both times I was treated. Now we are supposed to PCS to freaking Mississippi and they are giving us issues. I am sick of it and don't want to deal with it anymore. Help?

    ReplyDelete
    Replies
    1. My husband left the Army, so this is no longer a problem for me. All I can tell you is to stand your ground. EFMP sucks if you don't need it.

      Delete
  17. The power they give to an EFMP representative. I reprimanded the EFMP person for being 49mins. late and now they are trying to ruin my husband's career because I sought a medical therapist one time three years ago. The therapist clearly stated it was an adjustment anxiety disorder and now my husband is being penalized for this because I pissed the wrong person off. She combed my records for three hours and scrutinized every wording to have me enrolled into the EFMP program for something I do not get seen for... I felt disrespected and harassed! This cannot be right! Don't I have rights?

    ReplyDelete
    Replies
    1. Perhaps it would be worth your while to fill out an ICE complaint. This kind of thing is one reason why I hate that family members typically have their records so easily accessible to military folks (because they use military treatment facilities). It sucks that you don't have more privacy if you want to move abroad.

      Delete

Comments on older posts will be moderated until further notice.