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Military Behavioral Health Services Alan Ogle, Maj, USAF, BSC
Military Psychology PSY4990
University of West Florida, Spring 09
Disclaimer: information in this briefing was compiled from multiple sources in the US military medical services. Many have been modified or shortened to fit the educational purpose, format and training time available. Views expressed are those of the author and do not reflect the official policy or position of the United States Air Force, Department of Defense, or the U.S. Government. Why We Do What We Do Air Force Psychologists 42P Career Field
Clinical Psychologist (AFI 44-119)
204 Active duty
9 Fellowships
22 Residents
Current approx 70% manned Postdoctoral Fellowships Child Psychology
Neuropsychology
Clinical Health Psychology
Forensic
Combat/Aviation Psychology
Psychopharmacology Scope of Practice Clinical interviews and psychological assessment
Diagnose and treat mental disorders
Provide individual, marital, and group treatment
Recommend administrative and medical dispositions
Perform dangerousness assessments
Determine degree of impairment for military service
Serve on competency and sanity boards
Commander’s consultant on behavioral health issues 7 Behavioral Health Services MENTAL HEALTH CLINIC: Voluntary Care Talk therapy: individual, marital, families
Education classes: stress, anger, couples communication, seasonal “blues”, healthy alcohol use, suicide/violence prevention, others upon request
Special evaluations: Command Directed,
security clearance, fitness for special duty
Confidentiality and limitations
Risk of harm to self/others
UCMJ
Fitness for duty
Patient Issues Depressed Mood
Anxiety
Stress
Work or Life Events
Relationships
Parenting Concerns
Adjustment
Grief
Deployment-related issues ALCOHOL AND DRUG ABUSE PREVENTION AND TREATMENT (ADAPT Program ) Promote readiness, health and wellness through prevention and treatment of substance abuse
Minimize negative consequences of substance abuse to individual, family, and organization
Provide education and treatment for individuals with substance abuse problems
Return patients to unrestricted duty status or assist them in transition to civilian life 11 Substance Misuse: A Clear and Present Danger AF average of ~ 5300 Alcohol Related Incidents/Year (e.g. DUI/DWI & underage drinking)
Alcohol misuse is involved in:
33% of suicides
57% sexual assaults
28.5% domestic violence cases
20-25% PMV accidents
“Alcoholism” should not be our sole focus!
Substance misuse directly impacts mission effectiveness… PREVENTION + DETECTION + TREATMENT = SUCCESS ADAPT SERVICES: EVALUATION AND EDUCATION All Referrals Receive:
Initial diagnostic evaluations
6-hour Substance Abuse Awareness Seminar (SAAS)
Alcohol Brief Counseling, pilot testing at 15 bases
85+% success = No further ARM
Education Topics
- Military and civilian standards -Hazards of binge drinking
- Individual responsibilities -Family Dynamics of substance abuse
- Legal/administrative consequences -DUI/DWI education
- Facts and statistics about alcohol -Drug abuse education
- Physical and psychological effects -Values clarification
- Impact on self, others, and community -Healthy stress management
- Biopsychosocial Model of addiction -Decision-making and goal setting skills ADAPT Services: Treatment Patients with substance use disorder receive treatment
Alcohol Abuse / Alcohol Dependence
Treatment options: Outpatient, Intensive Outpatient, Partial or Full Hospitalization Programs as clinically indicated
Family and unit involvement
Duration ~4 - 24 months
Successful completion of treatment is condition for continued employment
“Treatment failure” AF rate = ~2%
Behavioral Health in Primary Care Act as consultant and member of Primary Care team
Support PCM decision making and build on PCM interventions
1-3 brief (~20-30 min) patient consultation sessions:
Educate patient in self management skills
Improve provider-patient working relationship
Effective triage of patients in need of specialty behavioral health
Avoid MH stigma—not therapy, no mental health records Typical Areas of Consultation Family Advocacy Program Family Advocacy Program OPR for the prevention and treatment of domestic violence
Works to reduce the number and severity of family maltreatment incidents
Prevent where possible…treat where needed
All DoD personnel are mandatory reporters of domestic violence
Assess and intervene: physical abuse, emotional abuse, neglect of spouse or child
Promotes alliance between leadership, agencies and community to:
Facilitate an atmosphere of nonviolence in work and home
Encourage member and family asset and skill development
Enhance victim safety
Build member and family strengths
Services provided through Outreach Prevention Program; New Parent Support Program; Treatment Intervention Drug Demand Reduction Program
All military members are subject to drug testing regardless of rank or status
Random selection
Maintain chain of custody
DDR supports administrative/UCMJ actions
All Active Duty Service Members Drug Positives
FY03 % personnel with positive drug test(s)
DoD Air Force Army Navy Marines
1.26% 0.41% 1.76% 1.21% 1.26%
Displays at the BX, Commissary, Community Center, Youth Center, Post Office, Medical Clinic, and Library
OCTOBER 25, WEDNESDAY
PUPPET SHOW--Kindergarten, grade 1, 2 and 3
08:40 -- 9:15 --Mrs. Mailloux, Mrs. Lerner, Mrs. Edwards, Ms. Beavers
9:30 -- 10:00 -- Mrs. Becker, Mr. Becker, Ms. Glass, Mrs. Weiland
DISCUSSION/Question/Answer time Grade 4 and Grade 4/5
11:00 - 11:30 -- Dr. Westbrook and Ms. Sullivan
11:30-1230 High school
12:30-1:30 staffed table at high school
OCTOBER 27 FRIDAY
DISCUSSION/Question/Answer time Grades 5/6
9:15 -- 9:45 -- Ms. Henderson & Mrs. McVay
10:00 -- 10:30 --Mrs. Wilson
11:30-12:30 Middle School
12:30-1:30 staffed table at middle school Tribase United Against Drugs & Alcohol Abuse Traumatic Stress Response Team Team of Mental Health, Chapel, and AFRC personnel
Provide support to units and community after traumatic events Command Consultation Mental Health Issues
Suicide Prevention
Violence Prevention
Family Maltreatment Prevention
Hostage Negotiation Team Consultant
Community Issues INDIVIDUAL LEVEL Pre-Screening
Treatment Education
Discipline BASE
LEVEL Awareness
Education
Prevention
Intervention
Alternatives COMMUNITY
LEVEL Collaboration
Responsible
Alcohol
Service
Disciplinary
Control
Board Alcohol Prevention SME LEADERSHIP
CULTURE
OF
RESPONSIBILITY Community Surveys Survey Results Example—Community Needs Assessment Top Community Concerns—issues in red targeted for intervention:
#1 Transportation when arrive (90 people)
#2 Long work hours (71)
#3 Finding housing (68)
#4 Sense of Community (67)
#5 Fitness facilities for parents with young children (60)
#6 Lack of childcare (59)
#7 Sponsorship program (56)
#8 Deployments (41)
#9 Heavy drinking (36)
#9 Marital problems (36)
#10 English culture (35)
#11 Financial management (30)
#12 Working in Joint environment (29)
#13 Fighting (23)
#13 Parenting Skills (23)
#14 New parents support (13)
Items not CCAP targets referred to applicable agency Community Action Plan Progress Check Deployments Mental Health Rapid Response Team
Combat Operational Stress Control (COSC)
Behavioral Science Consultation Team (BSCT)
SOF Psych
6 months duration
Currently Air Force has 17 mental health deployment missions (12 are Joint Expeditionary Taskings, i.e. for the Army)
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