By Ms. Suzanne Ovel (Army Medicine)April 26, 2018
JOINT BASE LEWIS-MCCHORD, Washington -- Whether they're struggling with marital strife, grief, combat-related stress or other issues, service members can get easy access to behavioral health care. Across Army Medicine, Madigan Army Medical Center is one of just a handful of locations that offers all 12 behavioral health service line programs in house.
"Here at Madigan we offer the entire gamut of behavioral health programs that are available," said Lt. Col. Kevin Goke, the installation director for psychological health and Madigan's chief of behavioral health. "We offer a wide range of everything from outpatient treatment processes to inpatient care, to everything in-between."
The programs cover everything from outpatient to inpatient care, as well as intensive outpatient programs, substance abuse treatment, family advocacy, child and family behavioral health care, support of traumatic brain injuries, and more.
Goke explained that offering the spectrum of care at Madigan, along with the hospital's new unified electronic health record, MHS GENESIS, provides patients with better continuity of care.
The embedded behavioral health teams in particular let service members easily access behavioral health care right in their unit areas. Not only do service members spend less time traveling to appointments, and therefore less time away from their units, but being enmeshed in operational units removes some of the stigma of seeking care.
"When you're in and around the commands and Soldiers, they're more likely to seek you out," Goke said.
Since the EBH teams began embedding with line units in 2011, they became an ingrained part of those units' cultures; to service members fresh out of training, the EBHs have always been available.
"They're willing to come in and get care … they realize they can go get care and not be treated as broken," Goke said.
The EBHs offer everything from individual to group therapy, to include areas like anger management. Many Soldiers benefit from groups because the shared experiences of their peers can resonate better than some of the input from providers.
In fact, "some of the Soldiers will advocate because they realize how much better they've gotten," Goke said, explaining that some service members even encourage others to attend counseling.
The EBHs also work to build close relationships with the command as well to keep them informed of generalized trends across the units, such as issues with sleep, relationships or leadership.
While some service members question whether seeking behavioral health help could impact their careers, Goke stressed that there are, in fact, very limited situations in which behavioral health providers must share information with commands.
"By doctrine, there are only two diagnoses that limit your career, and that is bipolar disorder, because that includes some manic behavior, and a psychotic disorder, and those are extreme ends of the diagnosis," Goke said. "There's very, very few things outside of psychosis and acute safety issues that will be an automatic kind of 'check the box' that will limit your career. Many people receive behavioral health treatment and either the command is never aware, or even when the command is aware, that never get separated from service or put into a med board."
In fact, if patients do want more information shared with their command, they need to provide permission, and specifically need to sign a Department of Army release form.
Moreover, leadership from the top levels of the Army on down are opening up more about their own behavioral health struggles and treatment to let others know it's okay to get help.
"The last sergeant major of the Army got up and spoke about his marital treatment, and that's something that's very positive," Goke said.
He shared that it's actually normal for people to struggle after major life stressors such as combat, divorce or a death in the family -- just as normal as needing a cast and time off after breaking a bone. If the stress, and the struggle, make a service member wonder if they're not maintaining readiness, behavioral health can help them as well, he said.
Even service members who don't have an EBH team in their units still are assigned to behavioral health clinics at Madigan; the Denali Behavioral Health Home serves as the catch-all if they're not already assigned elsewhere. Primary care clinics also now staff behavioral health consultants who work directly with the other clinic staff for easy accessibility to their patients.
In addition to help for combat stress and other combat-related issues, Madigan's behavioral health providers offer services to include anger management, stress management, sleep groups, grief counseling, sexual harassment or assault support, and other behavioral health concerns.
"If you're struggling with kind of the weight of the world … we're going to help you cope," Goke said.