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News | May 17, 2024

Joint Behavioral Health Conference Highlights Suicide Prevention and New Models of Care

Behavioral Health leaders from Defense Health Network East and Military Readiness Command East gathered here to share best practices and highlight new programs that can improve care.

For two days, the group heard from DHN East, MRC East and Defense Health Agency leaders on various topics that included pilot programs, telehealth, suicide prevention, PTSD, current research, and best practices. They discussed how to increase care capacity, involve installation and other support agencies in treatment and how to successfully lead their clinics.

“There has been a significant Army-wide focus on the importance of behavioral health," said U.S. Army Col. Liquori Etheridge, director of Psychological Health, MRC, East. "We focus on addressing the challenges within the behavior health field to include meeting the increased access to care demands impacting both healthcare delivery and readiness of service members.”

A nationwide shortage of behavioral health providers along with the increase in demand has led the Military Health Service to look for ways to continue to provide care.

One way is an expanding a DHA program called Targeted Care, which started as a DHA pilot at 10 sites (none from DHN East) in Spring 2023. A DHA release stated, “the program intends to connect service members with non-clinical and clinical resources, depending on their mental health experience.”

Conference attendees heard about Targeted Care from DHA’s Outpatient Behavioral Health, Behavioral Health Clinical Management team clinical director Dr. Angelica Escalona, and program manager Mr. James Sarver about their experience implementing the pilot. The pilot lasted for six months, was designed according to a DHA release to “connect service members with non-clinical and clinical resources, depending on their presenting condition or need.”

In their briefing Dr. Escalona and Mr. Sarver highlighted how the pilot showed 40% of individuals seeking help at outpatient behavioral health clinics did not require medical intervention or have a diagnosable condition. Military and Family Life Counselors were the highest vectored resource. They also emphasized an important aspect of Targeted Care involves socialization and coordination with non-clinical or other helping resources within an installation (i.e., MFLCs, chaplains) before starting the vectoring process.

Another important point made was that vectoring is a collaborative process between the individual, a behavioral health technician, and provider. Individuals are only vectored to another resource if they agree that it best meets their need. If the individual would rather be seen in behavioral health, they will not be denied behavioral health specialty services said Escalona.

“We saw many outpatient behavioral health clinics substantially lower time from request to appointment by vectoring individuals to appropriate clinical and non-clinical resources, increase their use of group therapy with positive results, and improve synchronization with helping resources within the installation,” said Dr. Escalona. “Overall, it was a great success and we’re seeing others using the principles from the pilot to improve the workflow in their outpatient behavioral health clinics.”

On post-traumatic stress, attendees heard from Command Sgt. Maj. (retired) Daniel Pinion who gave a first-person account of combat experiences that had a tremendous impact to his life. After returning from nearly three years at war, and suffering effects of losing Soldiers under his responsibility, an assault of another Soldier landed Pinion in behavioral health. There he spoke with a counselor who saved his life and began his road to recovery that continues today.

Pinion, a published author, was not in the medical field during his time on active duty, but took his current position with MRC, East as the deputy chief of staff for operations, plans and training to give back to those who helped him through the most difficult times of his recovery.

“I am grateful for the many medical providers who spent and continue to spend countless hours helping me understand and work though what I witnessed and how to come to terms with it,” said Pinion. “I’m still working through the emotions and don’t think I will ever be free of them, but I’m at a point where I can discuss what happened without reliving it.”

Day two primarily focused on suicide to include a brief on the lethal means of suicide prevention. A key take-away from one discussion focused on “establishing a gap between the onset of a crisis or a suicidal ideation and the individual acting on that ideation,” said Col. Etheridge. “Creating this gap is the only proven method that shows significant effectiveness in terms of reducing suicide.”

In an interview after, Etheridge highlighted that statistics show having firearms not available when a Soldier is in crisis makes a significant difference in outcome. He said that readiness and health are working on a cultural shift in how Soldiers store personal firearms. This includes voluntarily handing over a firearm when a Soldier knows they are having ideations to a buddy or that buddy taking the firearm of a Soldier in crisis if it can be done safely. Etheridge stressed that more research and discussion will be required before anything is implemented.

Overall, the conference attendees left with greater understanding of changes in military behavioral health that they can take back to improve how they provide care and support beneficiaries in their military treatment facility or units, said Etheridge.

This was the first conference for the behavioral health leaders since the realignment of health care under DHA and MRC, East's redesignation.
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