Commentary: tele-behavioral healthcare to help where needed
January 21, 2010
WASHINGTON (Army News Service, Jan. 21, 2010 ) -- As part of an increasing commitment to addressing behavioral health care for Soldiers, families, and retirees, several tele-behavioral health initiatives are under way.
Tele-behavioral health provides high-quality, cost-effective, timely access to outpatient behavioral health care, regardless of the location. Many people are reluctant to seek behavioral health care because they're afraid a "stigma" surrounds behavioral health problems.
When tele-behavioral health programs began in August, Army Vice Chief of Staff Gen. Pete Chiarelli said "I believe we have taken a very important first step in getting behavioral health care to Soldiers and family members who might not have received it otherwise, because of stigma or geographical separation."
With online care we have found a resource that aids in overcoming limited provider availability, geographic distance, scheduling difficulties and the social stigma that sometimes surrounds seeking psychological health care.
On Aug. 1, TRICARE (the Department of Defense's health care program for members of the uniformed services, their families, and survivors) expanded its services to include two new online video behavioral health programs: the TRICARE Assistance Program, TRIAP; and Tele-behavioral Health, which were developed to help eliminate obstacles to seeking treatment.
TRIAP includes online assessments via Web sites, short-term counseling, and referral to more intense treatment, if necessary. Tele-behavioral Health involves a network of kiosks that provide video tele-conferencing sessions with behavioral-health specialists.
Both programs are available to active-duty servicemembers and their families. Also eligible are reserve-component servicemembers and families enrolled in TRICARE Reserve Select or those eligible for the Transitional Assistance Management Program known as TAMP for 6 months following redeployment. Family members must be 18 years or older to use this type of tele-behavioral health care.
Referrals and prior authorization to use TRIAP are not needed. Assistance counselors are available to provide confidential, private discussion which can include family/relationship issues, stress management, and self-esteem issues. Each TRICARE region has developed a site for TRIAP which can be accessed through the Web site: http://www.tricare.mil/mybenefit.
Using both the Army Medical Department and TRICARE behavioral-health networks will streamline and improve access for Soldiers so that symptoms and risk of suicide can be identified and treated much earlier.
In addition to the TRICARE tele-medicine programs, the Department of Veterans Affairs' Suicide Prevention Campaign is expanding its own outreach to all veterans by piloting an online one-on-one chat service for Veterans who prefer reaching out for assistance through the Internet. The Veterans Administration Web sites provide a link to an online live chat for tele-behavioral health at: <a href="http://www.mentalhealth.va.gov/" target=Aca,!A?_blank"> http://www.mentalhealth.va.gov/</a> or <a href="http://www.mentalhealth.va.gov/suicide_prevention/index.asp" target=Aca,!A?_blank">http://www.mentalhealth.va.gov/suicide_prevention/index.asp</a>.
The Army is also working to identify ways to provide more virtual behavioral health care. A Virtual Behavioral Health Pilot Program was conducted at Schofield Barracks, Hawaii, in October and November. The purpose of this Army pilot project was to compare the effectiveness of face-to-face counseling vs. counseling provided through video-teleconferencing and to determine the technical requirements for tele-behavioral health counseling.
Tele-behavioral health care systems are thought to be sustainable and useful in providing services to locations where regular behavioral health care cannot be obtained due to access barriers (geographic, immobility, or stigma), or a shortage of BH providers.
In the pilot project, Soldiers were first assessed immediately upon returning from deployment. These same Soldiers were assessed again two-three weeks later to identify any symptoms that may have developed during the first few weeks back from deployment, called the reintegration period.
Initial results from the Army's Virtual Behavioral Health Pilot Program project are highly encouraging and the Army plans to expand the virtual behavioral health options to other locations.
Whether the programs are TRICARE, VA or Army, in the future, Soldiers deployed to remote locations can expect to see and use more of this new technology.
The benefits of this technology are great, where in the past we may not have been able to offer services because of the Soldiers geographic location, we can now leverage this new technology and provide services to anyone at any location.
(Lt. Col. Edward Brusher serves as deputy director, Behavioral Health proponent, Office of the Surgeon General)