The Department of Defense recently updated a policy on command notification requirements regarding the private nature of mental health care services, which outlines confidentiality guidelines.
The goal is for servicemembers to be able to seek mental health care services or substance abuse treatment as easily and comfortably as any other medical services, without fear of command notification or professional sanction.
“If you need or want help, go see someone. You have a lot of options” within the DOD, said U.S. Navy Capt. (Dr.) Kenneth Richter, director of mental health policy and oversight in the Office of the Assistant Secretary of Defense for Defense Affairs. health.
On September 6, 2023, Gilbert R. Cisneros, Jr., then Under Secretary of Defense for Personnel and Readiness, approved the release of DOD Instruction 6490.08. It sets out procedures for maintaining the confidentiality of individuals seeking treatment for mental health or substance abuse problems and “promotes the reduction of stigma related to obtaining mental health care services by balancing patient confidentiality with the need of a commander to know certain information for military operational and risk management decisions.”
“No Wrong Door” Approach to Mental Health Care
“DOD is taking a ‘no wrong approach’ to behavioral health services to foster a culture of support,” said Dr. Donald Shell, Acting Executive Director, Health Services Policy and Oversight, Office of the Secretary Deputy Defense Minister for Health Affairs.
THE Brandon Law allows servicemembers to initiate a referral for a mental health assessment through a self-assessment to a supervisor or commander. Recent military services implemented the first phase of the act.
While military members may have misconceptions about mental health care, McConnell Air Force Base, Wichita, Kansa, clinic professionals serve to support Airmen and improve their quality of life and performance through comprehensive programs advice and guidance. McConnell’s mental health clinic is available to all Airmen and is part of the Department of Defense’s efforts to destigmatize mental health care. (US Air Force photo by Senior Airman Nilsa Garcia)The Defense Health Agency has many ways to access mental health services and support. Covered services include outpatient and inpatient behavioral health treatment for urgent and non-emergency mental health needs. Care is offered through in-person or virtual appointments at military hospitals and clinics and through the TRICARE network of civilian providers.
Behavioral health services are medical and non-medical. At military hospitals and clinics, servicemembers have access to primary care behavioral health care, specialized outpatient behavioral health programs, alcohol and substance use programs, inpatient, and outpatient programs intensive.
Outside of military hospitals and clinics, service members can receive support through military and family life counseling provided by Military OneSource integrated behavioral health, family advocacy programs in each of the military services or through Military OneSourceMilitary family preparation provided by Military OneSource, the inTransition program and chaplains.
Perceptions about mental health care are changing
The data indicates a growing demand for mental health services, which can be interpreted as an increase in help-seeking behaviors, Shell said.
A FY 2023 report to Congress on TRICARE showed the growing demand for behavioral health services across the DOD. The report found that:
- Fifty-one percent of behavioral health providers are accepting new TRICARE patients
- 1,311 behavioral health facilities accepted TRICARE in FY 2022 and 2,295 were planned for FY 2023
“As we continue to combat stigma and promote help-seeking, DOD and the civilian sector will face new challenges associated with demand outpacing supply of behavioral health care providers,” Shell said .
How DHA integrates mental health care
To improve access and outcomes for people receiving behavioral health treatment, DHA Direct careDirect care refers to military hospitals and clinics, also called “military treatment facilities” and “MTFs.”direct care The system integrates “specialists into primary care centers to provide more continuous and comprehensive care within the primary care setting and to facilitate coordinated care,” the TRICARE report states.
The majority of health care facilities serving adults enrolled in TRICARE have integrated behavioral health specialists. “Direct onboarding of behavioral health providers ensures that onboarded specialists are able to work closely with the patient, primary care leadership, and the patient-centered medical center medical team; furthermore, because the specialties share a location, it helps to destigmatize the care received,” the report states.
“The Uniformed Services University of Health Sciences determined that being seen by a behavioral health specialist embedded in a PCMH results in a statistically significant improvement in mental health status,” according to the report.
THE True Warriors Campaignestablished in 2009, was expanded in 2023 through collaboration between the Psychological Health Center of Excellence and the Defense Suicide Prevention Office to increase suicide prevention initiatives. The RWC is a public health campaign that promotes a culture of support, emphasizing that mental health is healthand is designed to reduce stigma, increase psychological health knowledge, and promote help-seeking behavior.
DOD Actions to Reduce Stigma
On September 28, 2023, Secretary of Defense Lloyd J. Austin III issued a note lead 24 urgent actions to fight against suicide in the military community which is based on two years of important work in suicide prevention through the DOD.
The actions cover five lines of effort:
- Foster a favorable environment
- Improving the delivery of mental health care
- Addressing stigma and other barriers to care, including stigmatizing language
- Review suicide prevention training
- Promote a culture of lethal means safety
Actions are consistent with Austin’s Caring for our people initiative and highlight DOD’s commitment to the well-being of the Total Force, a DOD press release states.
DOD aims to fully implement each line of effort by the end of fiscal year 2030.
“Suicide prevention is a long-term effort,” Austin said. “Change will not happen overnight, but we have no time to lose. »
“We need to foster trust and connections in workplaces and in the communities we care for,” Austin said. “We must integrate prevention into all our efforts. And we need to reach out to those who are struggling and make it easier to find help. Caring for our people is a sacred obligation, and we will continue to do it with the determination and moral clarity that our teammates deserve. »
“Over time, asking for help will become a sign of strength for more people and, ultimately, mental health care services will be widely viewed as an essential part of individual performance,” he said. he declared.
DOD’s message is clear, Shell said. “The department is committed to protecting military personnel and their families. It will continue to address behavioral health challenges and promote help-seeking behaviors through a public health approach using evidence-based and evidence-informed methods to provide quality care, with the best outcomes, to a strength ready for use.
Resources
For anyone experiencing a mental health crisis, needing immediate help or simply wanting to talk to someone, confidential help is available 24/7.
Military OneSource is a 24/7 gateway to trusted information for military members and their families, providing resources and confidential help. Call 800-342-9667.
Chaplains also provide confidential counseling and play an important role in promoting spiritual preparedness and resilience.
THE Psychological Health Resource Center is available 24/7 to military members, veterans and their family members who have questions about psychological health topics. Qualified mental health consultants can help you access mental health care and community support resources in your area. Call 1-866-966-1020, start a live chator visit www.health.mil/PHRC.
The inTransition program offers 20 FAQs that provide a helpful introduction to the program. You can call 800-424-7877 or 800-748-81111 in Australia, Germany, Italy, Japan and South Korea only. You can also send the program directly by email to:dha.ncr.j-9.mbx.inTransition@health.mil.
THE Military health system, the DOD and the Department of Veterans Affairs have many other mental health resources available to any military member, family or veteran beneficiary who is struggling with mental health issues. Read Mental health is health care for a complete list of resources for immediate assistance or to schedule an appointment.
To make a mental health appointment through TRICARE, visit: www.tricare.mil/MentalHealth.
