Effectiveness of Pre-Deployment Mental Health Support and Care Coordination Program

Thursday January 20, 2011

What it is?

On Jan. 18, 2011, the American Journal of Psychiatry published results of an Army study that reports on the success of pre-deployment mental health support and coordination of care that reduced adverse behavioral health outcomes for Soldiers who received pre-deployment support prior to deployment.

What the Army has done?

The Army piloted a pre-deployment Mental Health Support and Care Coordination Program at the Fort Stewart, Ga., Soldier Readiness Processing site prior to the 3rd Infantry Division's (ID) deployment to Iraq in 2007-2008. The three Brigade Combat Teams that received the pre-deployment program were similar in demographics, number of prior deployments, and combat experiences as the three that did not receive the program. After six months, Soldiers from the brigades that received the pre-deployment support and coordinated care had significantly lower rates of combat-operational stress reactions (15.7 percent vs. 22.0 percent), treatment for behavioral health diagnoses (2.9 percent vs. 13.2 percent), suicidal ideation (0.4 percent vs. 0.9 percent), behavioral health duty restrictions (0.6 percent vs. 1.8 percent), and air evacuation from theater for behavioral health conditions (0.1 percent vs. 0.3 percent).

What does the Army have planned for the future?

The results show the Army, as part of its Comprehensive Behavioral Health System of Care Campaign Plan, is moving in the right direction implementing new policies and programs to enhance pre- and post-deployment care coordination for Soldiers. This study demonstrates the ability to bridge the gap between identification through screening, as required by the National Defense Authorization Act for fiscal year 2010, Sec. 708 (Mental Health Assessments for Members Deployed in Connection with a Contingency Operation) and actively managing and coordinating care for Soldiers with existing behavior health concerns to insure a successful deployment that benefits the Army and continued support to Soldiers and families.

Why are the study results important to the Army?

The results are significant and provide the first direct evidence that a program that combines pre-deployment support and coordination of care that includes primary care managers, unit surgeons and behavioral health providers is effective in preventing adverse behavioral health outcomes for Soldiers. The results move away from a perception of use of mental health screenings by Army and DoD as a tool to "weed out" Soldiers and servicemembers deemed mentally unfit, to one of use and integration of behavioral health screenings as a routine part of Soldiers' and service members primary care during deployment.

Resources:

Army Behavioral Health

Related article: Study shows pre-deployment screening yields benefits

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SENIOR LEADERS ARE SAYING

"I really believe when we put more time between deployments that is going to be a huge factor in helping get at a lot of these problems. I really believe that dwell is one of the things we have to look at, and has an impact on all kinds of problems, not just suicides, but you know, all the things that fall short of suicide from relationship issues to drug and alcohol abuse, to high-risk behavior, to all those things. The more time we can get between deployments, the better off we'll be."

- Gen. Peter W. Chiarelli, Army vice chief of staff, emphasizing the connection between repeated deployments and post-traumatic stress and related issues

Army sees slight reduction in active-duty suicides

WHAT THEY'RE SAYING

"This system shifted away from the traditional mental-health paradigm of attempting to predict future behavior or inability to cope. Rather, the purpose of this process was to ensure that we were not deploying unsafe Soldiers based on present conditions, and ensuring that we were linking those who were deploying with the in-theater assets so that they could stay in the fight. The result is an effective process that enhances Soldier and unit safety."

- Maj. Christopher Warner, the 3rd ID's staff psychiatrist, supporting the Pre-deployment Mental Health Screening/Care Coordination Program study, developed by Army physicians and psychologists searching for a better way to track Soldiers with behavioral health issues, especially when headed overseas.

Study shows pre-deployment screening yields benefits

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