The well-being and psychological health of Soldiers and Families is a top Army priority. The Army continues to strengthen the behavioral health system of care. Our commitment to Soldiers and Families is steadfast and we affirm to provide a behavioral healthcare experience that is supportive, caring and compassionate. A healthy mind and body are essential to individual readiness and a key Army priority for Soldiers, Civilians, and Families.

Resources:

Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE): dcoe.health.mil

Army Behavior Health: www.behavioralhealth.army.mil

Military One Source: www.militaryonesource.mil

Army Substance Abuse Program: acsap.army.mil

Rehabilitation and Reintegration: www.armymedicine.army.mil/r2d

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Post-traumatic stress is treatable. There are a number of effective talk therapy and medication options that support a Soldier or patient's return to a healthy, productive and satisfying life. We acknowledge that health is both personal and individual and that there must be trust between those to whom we provide care and the health care team. Embedded Behavioral Health (EBH) is the reorganization of the traditional model of outpatient behavioral health services for Soldiers into one that is Soldier-centered, proactive, forward-positioned and aligned with active-component operational units.

Facts

What is PTSD? PTSD is a psychiatric disorder that may occur after exposure to trauma. Typical symptoms include hypervigilence, intrusive thoughts, flashbacks, numbness, avoidance, and nightmares. A systematic survey of the Army population conducted in 2008 showed that 15.8% of Army personnel were experiencing serious psychological distress, and 13.3% met screening criteria for PTSD.

The Army has numerous education, identification, and treatment programs for PTSD. The most common forms of psychotherapy for PTSD are cognitive-behavioral therapy and exposure therapy. Usually psychotherapy requires approximately 10 to 20 sessions, if possible on a weekly basis. There are several medications used to treat the symptoms of PTSD. These usually include anti-depressants such as selective serotonin reuptake inhibitors, more frequently referred to as Selective Serotonin Re-uptake Inhibitors.

Institutional programs that mitigate PTSD rates include Army Resilience Training, which offers institutional strength-based, positive psychology tools to aid Soldiers, Leaders and Families in their ability to grow and thrive in the face of challenges and bounce back from adversity. Training and information is targeted to all phases of the Soldier deployment cycle, Soldier life cycle and Soldier support system. The Army Comprehensive Soldier Fitness also provides a holistic fitness program for Soldiers, Families, and Army Civilians in order to enhance performance and build resilience.

The Army Deputy Chief of Staff for Personnel and The Army Surgeon General share responsibility for the prevention and screening for PTSD for both active and Reserve Component Soldiers serving in Overseas Contingency Operations. The Deputy Chief of Staff for Personnel has a Deployment Cycle Support Program aimed at Soldiers and Family members and The Surgeon General has a Combat and Operational Stress Control program aimed at Soldiers' behavioral health. Additionally, on 2 Sep 10 the Army launched the Behavioral Health System of Care Campaign Plan to standardize, synchronize, and coordinate behavioral health care across the Army and through the Army Force Generation (ARFORGEN) cycle. Currently, this effort has evolved into the Behavioral Health Service Line, with the intent to optimize care and maximize limited BH resources to ensure the highest care to Soldiers and Families.

During pre-deployment, Deputy Chief of Staff for Personnel (DCSP) provides extensive training to Soldiers and Family members on operational and combat stressors, and means to lessen the impact of deployment and traumatic events. The DCSP resources available to Soldiers include buddy aid, leadership support, chaplaincy services, primary care, and behavioral health services. Family members are instructed on their roles, responsibilities, ways by which they may cope more effectively, strategies for supporting their deploying Soldier, and ways to seek professional assistance.

Deploying Soldiers are introduced to Combat and Operational Stress Control concepts and resources to prepare for combat and operational stress. Since March 2011, all deploying Soldiers receive enhanced behavioral health screening, targeting, among other behavioral health concerns, PTSD.

Resources:

Military Mental Health Self Screening Program: www.militarymentalhealth.org

National Center for PTSD: www.ptsd.va.gov

National Institute of Mental Health: www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd

Army Dismounted Combat Blast Injury Task Force Report (June 2011)

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Army Medicine leads the Nation in recognition and treatment of traumatic brain injuries (TBIs) through aggressive research and clinical capability. Because Army Medicine is at the cutting edge of identifying brain injuries with a comprehensive policy and medical management system, most Soldiers are medically cleared and ready to return to duty due to early identification and treatment regimens. Research shows that TBIs, especially concussions, are overwhelmingly treatable; however, receiving prompt care, regardless of severity, is essential in maximizing recovery. The overwhelming majority of Soldiers with TBI have a mild injury and fully recover without lingering effects.

Facts

TBI is a disruption of brain function resulting from a blow or jolt to the head or an object penetrating into the brain. Severity may range from "mild" (also known as concussion) to "severe." Army Medicine identifies and implements the best methods to evaluate and treat every Soldier with TBI. The most commonly reported symptoms of concussion include headaches, dizziness, memory problems and sleep disturbances.

Army Medicine collaborates with, and leverages its partnerships with key Department of Defense and civilian organizations to improve its ability to diagnose, treat and care for those affected by TBI.

The number of Soldiers diagnosed with concussion has steadily increased among all Army Components with the sharp increase beginning in 2006 attributable to screening efforts and other early detection initiatives. Since 2000, 233,425 DoD Service Members worldwide have been diagnosed with TBI, 134,938 (58%) of whom are U.S. Army Soldiers.

Causes of TBI:

• Falls
• Motor vehicle traffic crashes
• Struck by/against events
• Assaults
• Blasts

Risk Factors:

• Males have twice the risk as females; highest risk is for males age 15"24
• Contact sports
• Risky behavior such as speeding, not wearing protective equipment etc.

Resources:

Army TBI Website: www.army.mil/tbi

NFL Evolution - Health & Safety: NFL Evolution.com

Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) - TBI: www.dcoe.health.mil/ForWarriors/TBIInformation.aspx

"Heads up: Concussion in Youth Sports" (CDC): www.cdc.gov/concussion/HeadsUp/youth.html

TBI Program Validation

Defense and Veterans Brain Injury Center: www.dvbic.org or call (800) 870-9244

Centers for Disease Control and Prevention: www.cdc.gov/injury or call (800) CDC-INFO

Telehealth and Technology - T2 (for app development): t2health.org

Traumatic Brain Injury DoD Special Report: www.defense.gov/home/features/2012/0312_tbi

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The Army is committed to taking care of Soldiers and Families. The Army desires what the Soldier desires - to heal, pursue their goals, and continue to lead proud, productive lives.

WTUs provide holistic care and leadership to Soldiers and their Families who are expected to require six months of rehabilitative treatment, and/or need complex medical case management. The Army is currently caring for more than 18,000 wounded, ill, and injured Soldiers and Veterans between Warrior Transition Units (WTU) and the Army Wounded Warrior Program (AW2).

Resources:

Warrior Transition Command: www.wtc.army.mil

U.S. Army Wounded Warrior Program (AW2): www.wtc.army.mil/aw2

AW2 Advocates: www.wtc.army.mil/aw2/advocates

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Army Medicine has a comprehensive approach to pain management that integrates the most effective conventional medical treatments with complementary therapies such as acupuncture, medical massage, movement therapy (yoga), and bio-feedback.

The Army's Pain Management Task Force Report has proven to be a seminal document in the transformation of the nation's pain management strategy and national efforts to address issues of overuse/abuse/diversion of prescription medications. Army's holistic pain management approach includes yoga, meditation, hypnosis, acupuncture, massage therapy, and biofeedback to manage Solders' pain, promote health, and decrease the need for medication in many cases.

Army Medical Command's Comprehensive Pain Management Campaign Plan is establishing centers of excellence for pain management and education within each medical regional command in order to provide state-of-the-art, evidence-based, outcome-oriented, cost-effective care for Soldiers suffering from acute and chronic pain.

Facts

• Pain is the most frequent reason patients seek physician care in the United States
• More than 116 million Americans suffer from chronic pain
• The annual cost of chronic pain in the U.S. is estimated at $560 billion, including health care expenses, lost income, and lost productivity
• Back pain alone is the leading cause of disability in Americans under 45 years of age
• IOM report "Relieving Pain in America", June 2011

Resources:

Pain Management Task Force Final Report (May 2010)

Pain Management Initiative

Pain Management Campaign Plan

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Our wounded Soldiers receive definitive care for multiple conditions that may require treatment with multiple medications. Prescribing practices in the Army are consistent with the medical standard of care practiced in the civilian community. Clinicians must meet the same training, licensing, and credentialing requirements as their civilian counterparts to ensure clinical competence and patient safety.

Facts

Pharmacists have been assigned to Warrior Transition Clinics to provide close medication management support in order to optimize the use of psychotropic and pain medications while reducing risks.

Successes with medication management in Warrior Transition Clinics led to expansion pilots at division Brigade Combat Teams (BCTs) to aid providers in communication with Soldiers and Commanders, ultimately enhancing patient safety and optimizing medical care.

• Prescription drug overdose deaths now exceed deaths from cocaine and heroin
• American deaths from prescription drug overdoses now exceed motor vehicle fatalities
• Non-medical use of prescription painkillers: $72.5 billion annually in direct health care costs to health insurers
• CDC declares Rx medication abuse an "EPIDEMIC" in the United States

Resources:

Collaboration with for DEA National Prescription Medication Take Back Day

On April 28th, the Army will be collaborating with DEA for the 3rd time on the National Prescription Medication Take Back Day.

This is combined effort between IMCOM (installation safety), OPMG (law enforcement), and MEDCOM.

This is opportunity to join national dialogue on this important issue of prescription medication abuse and diversion

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