Behavioral Health clinics are another tool for suicide prevention

By Vanessa Lynch, U.S. Army Garrison-Hawaii Public AffairsJuly 29, 2010

Part three of the series reviews SELF-evaluations, Soldier Assistance Center and Virtual Behavioral Health programs

SCHOFIELD BARRACKS, Hawaii - Words like behavioral health and suicide prevention seem embedded into the minds of Soldiers, and with more attention focused on resiliency training and redeployment health, Soldiers may think they don't need help.

However, Soldiers may need help more than they know.

"The Army is very concerned about our active duty Soldiers' and families' well-being," said Col. C.J. Diebold, chief, Department of Psychiatry at Tripler Army Medical Center and psychiatry consultant to the Army Surgeon General, Medical Corps. "There has been a significant shift from treating conditions when they occur to preventing them from happening all together.

"Suicide prevention is a very big issue right now," Diebold said. "The Army is being very aggressive in educating people. Our biggest challenge has been getting rid of the stigma that seeking help will negatively affect (a Soldier's military) career. That is simply not the case. Seeking help is strongly encouraged."

Echoing Army Vice Chief of Staff Gen. Peter Chiarelli's remarks in his letter to leaders, Diebold said a Soldier's chain of command needs to endorse that seeking a chaplain for help or going to behavioral health is not a sign of weakness.

"There has always been a big emphasis on being physically ready to do the job, but now the Army is looking at how to better equip the whole Soldier," Diebold said. "One big thing is the importance of Comprehensive Soldier Fitness. It's along the lines of taking a look at the entire person and what their needs are - biological, psychological and social - throughout the entire life cycle. It's not only how we can deal with problems, but how can we make people more resilient."

SELF Assessments. The Soldier Evaluation for Life Fitness, part of CSF, assesses Soldiers' behavioral health issues during the first week of reintegration and during the 90-to-180-day post-deployment health assessment window. SELF helps Soldiers resolve deployment-related issues and other physical and behavioral health concerns through individual coaching sessions.

The SELF-assessment consists of a computerized survey and clinical interaction interview conducted by a health provider.

"Since every Soldier receives a medical consultation on-site, no one is stigmatized if he or she is being seen by a behavioral health care provider. Everyone gets a chance to talk," said Dr. Kelly Bickel, chief, SELF Clinic. "Everything here is very private. Follow-up appointments are made in the provider's office, so a Soldier never has to walk into the lobby area to make an appointment to come back. They can walk out like nothing happened."

Soldier Assistance Center. Another place Soldiers can turn to for help is the Solider Assistance Center. The SAC provides psychological and psychiatric services for active duty Soldiers.

"One of the things we hear often from Soldiers is that they would rather be sent back to Iraq because they don't know how to assimilate into everyday life," said Dr. Christine Fair, officer in charge, SAC clinic chief. "They don't know how to go back to being a father or a husband. They are not used to dealing with traffic, having to go grocery shopping or paying the bills. They habituate into combat."

SAC services include crisis counseling, comprehensive behavioral health evaluations, individualized treatment plans, medication evaluation and management, individual and group counseling, psychological testing, and command-referred evaluation and consultation.

"Soldiers need to be mentally fit to do their jobs," Fair said. "The brain runs the body. If the brain is not working properly, it won't allow the Soldier to be the best Soldier that he or she can be."

Pilot Programs. In an effort to identify ways to provide more virtual behavioral health care, a Virtual Behavioral Health Pilot Program was also conducted at Schofield Barracks, last year. The pilot compared the effectiveness of face-to-face counseling versus counseling provided through video-teleconferencing.

Tele-behavioral health care systems are thought to be sustainable and useful in providing services in locations where regular behavioral health care can't be obtained due to access barriers such as geographic, immobility, stigma or a shortage of BH providers.

"The Army is in a long-term conflict, with some Soldiers experiencing repetitive deployments into combat and high-stress environments," said Dr. Brenda Edmonds, chief, behavioral health, Health Policy and Services, Pacific Regional Medical Command. "Stress reactions and behavioral health support requirements are at an all-time high. It is imperative to help manage the stress the Soldiers are experiencing. This means doing everything we can to help Soldiers with the normal stresses of combat and deployment, before, during and after, to include maximizing the availability of behavioral health care providers," Edmonds said.

<u>Soldier and Family Assistance Center</u>

The Schofield Health Clinic is the home of the Soldier and Family Assistance Center, an umbrella organization consisting of four behavioral health clinics. The SAFAC offers the following services:

Aca,!AcActive duty Soldiers via the Soldier Assistance Center, 808-433-8600;

Aca,!AcAdult family members through the Adult Family Assistance Center, 808-433-8130;

Aca,!AcChild and adolescent family members at the Child and Adolescent Assistance Center, 808-433-8175; and

Aca,!AcMarriage and family therapy services at Marriage and Family Therapy Center, 808-433-8550.

<u>Military OneSource</u>

Military life comes with unique challenges. Military OneSource provides expert information, articles, booklets, CDs, DVDs and links to other resources on how to deal with issues like education, relocation, deployment, parenting and stress. Visit <a href="http://www.militaryonesource.com">www.militaryonesource.com</a>.

Available by phone or online, Military OneSource is a free service provided by the Department of Defense for active duty, National Guard and Reserve service members and their families. Consultants offer confidential support and practical solutions, 24 hours a day, seven days a week. Call 800-342-9647 to talk to a consultant, or call the National Suicide Prevention Lifeline at 800-273-8255.

(Editor's Note: This is part three of a three-part series. Click <a href="http://www.hawaiiarmyweekly.com/news/2010/7/16/resiliency-services-work-to-combat-suicides-with-prevention.html">here</a> to read part one or click <a href="http://www.hawaiiarmyweekly.com/news/2010/7/22/survey-identifies-suicide-risks.html">here</a> to read part two.)

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