Military Mental Health Operations

Ch 2,8

Disclaimer

• Information and opinions expressed by Maj Dhillon and other military/government employees providing lectures are not intended/should not be taken as representing the policies and views of the Department of Defense, its component services, or the US Government.

Overview• Mental Health Clinic• Alcohol and Substance Abuse Clinic• Family Advocacy • Resiliency Element• Director of Psychological Health• Suicide Prevention

Mental Health Clinic• Providers have clinical skills to eval/treat any

disorder & arrange for higher level of care PRN• Serve AD, dependents, retirees, foreign svc

mbrs/dependents, nationals of foreign countries, enemy combatants

• Composed of AD Os/Es, contractor, & GS providers

• Multidisciplinary • Governed by Department, Service, & Unit lvl

instructions

Mental Health Clinic• Tx (therapy, meds, combo)• Assessment• Command (CC) consultation• Psychoeducational Briefings• Clearances• Coordinate intensive care• Svcs by appointment and walk-in

Mental Health Clinic• Access to care 72 hours for initial appt,

immediate for crisis• Case load 4 pts for 50 min appts• Prescribers 50 min for intial/complex pt; 30

min for refills• Duty limiting conditions (DLCs)• High Interest pts• Inpatient unit discharge evals• After hours consultation

Alcohol And Substance Abuse Tx• USAF: Alcohol and Drug Abuse

Prevention and Treatment (ADAPT)• USA: Army Substance Abuse Program

(ASAP)• USN: Substance Abuse Rehabilitation

Program (SARP)

Alcohol And Substance Abuse Tx• Usually one officer and multiple MH techs• MH techs play large role in clinical care• MH techs can obtain CADAC certification• Medical Director to review labs• Prevention events across installation • Coord care with MHC for dual dx• ARI, referral eval: abuse, dependence, neither• Lvls of care .5, I, II, III • Aftercare tx for dependence after inpt tx• Psychoeducation for abuse

Alcohol and Substance Abuse Tx• Deglamorize alcohol use across the services• DoD: If CC or medical personnel suspect misuse of

ETOH or any illicit or Rx, referral to clinic mandatory• Self referrals recommended, no adverse job impact• Alcohol Related Incident (ARI) on base police blotter

released to clinic– Any incident where someone was under the influence by

any degree• ARI referrals most often lead to administrative action• No medical benefits if discharged from svc for

ETOH/Substance disorder

Family Advocacy• Healthy families are better for svc

mbrs and mission• Mainly LCSW • Manage cases of child maltreatment,

domestic violence• High visibility• Svc mbrs removed from duty if guilty

of domestic violence—Lautenberg Amendment

Family Advocacy• New Parent Support • Educational resources for new families• Home support visits for new mothers• Free car seat and car seat safety

instruction• Support for families with Special Needs• Marital/Family Therapy

Resiliency Element• Newest Element in AF Mental Health

Flights– Responsible for outreach for each element – Officer sits on board for installation’s

leadership in area of health, welfare, morale

Director of Psychological Health• Advisor to installation’s CC on issues

related to the mental health of the force

• Higher ranking mental health provider • Suicide prevention coordinator• Track suicide related activity• Most likely is officer appointed for

Resiliency

Suicide Prevention• AF Guide for Managing Suicidal Behavior– Annual Training– 18 initiatives– Not mandates, recommendations for clinical

mgmt• Developing Wingman, Battle Buddy culture– Ask– Care– Escort

Suicide Prevention• Efforts to destigmatize MH care, MFLC,

Military OneSource, Chaplain, unit support

• Outreach, Svc wide education• DoDSER—Means for suicide event

reporting across svcs

Suicide PreventionKristen Freeman, LCSW

Suicide Prevention CoordinatorVA Gulf Coast Health Care System