How do I know if my soldier needs help?
Army Reserve Soldiers comprise the most highly trained, ready, and lethal reserve force in American history. Although our soldiers are a strong and resilient group, there are circumstances and experiences that can challenge their coping mechanisms, and when this happens they may need help. Help for the soldier may be in the form of therapy, medication, lifestyle changes, and/or a combination of these things. Often soldiers are unaware of their need for help, or they are afraid to say something due to concerns about the stigma associated with behavioral health. As a Commander you have the ability to help your soldiers by encouraging them to come forward with their struggles and receive help without fear of stigma or negative impact on their careers. If you have questions about what steps to take or how to help, please give one of our staff of licensed social workers a call and we can help you develop a plan for helping your soldier return to optimal levels of mental fitness and readiness.
How EXACTLY does that work?
When you contact us we will discuss your concerns and will ask what you are observing or what has been reported to you about the soldier. It could be that the soldier has stopped attending battle assembly, or maybe the soldier’s behavior has changed from what is known to be his norm. Your soldier could be exhibiting signs of substance abuse, or it could be a significant change in performance. We won’t be able to diagnose or prescribe a specific treatment, but we may make some recommendations about how to proceed. Our first recommendation will likely include allowing us to reach out to the soldier directly so that we can engage with him in an effort to figure out what is going on and figure out what he may need in the way of help. If you need more information about the soldier’s issue we can walk you through the Command Directed Behavioral Health Evaluation process. We can provide information about temporary and permanent profiles, eligibility for care at the VA or through the DOD, and how best to support your soldier.
What is a Command Directed Behavioral Health Evaluation?
The Command Directed Behavioral Health Evaluation is a great way for Commanders to obtain information about a soldier’s mental status. The soldier receives an evaluation at a military treatment facility (MTF) by a military behavioral health provider and you, as Commander, are provided with a report, the DA Form 3822. This document will contain information about the soldier’s diagnosis, his fitness for duty, information about medication, and recommendations for treatment. It can provide enough information for you to make decisions about the soldier. The attachment below includes a step by step instruction on how to have the evaluation done, along with the Department of Defense Instruction that authorizes the evaluation, a sample of the DA Form 3822, a list of MTFs that perform the evaluation, and some sample request forms. Each MTF has their own request form.
<Click here for separate Word file with helpful guide for CDBHE>
What information am I allowed to know about a soldier in treatment?
All service members are entitled to confidentiality with regard to mental health treatment. Department of Defense Instruction 6490.08, Command Notification Requirements to Dispel Stigma in Providing Mental Health Care to Service Members provides clear guidance about what can be disclosed to Commanders. Within the Army there have been MEDCOM/OTSG policy memorandums published that also speak to this. That being said, Commanders are entitled to information about their soldiers. Some of the criteria include harm to self, others, or the mission. Commanders can ask for and receive information about appointments made and missed, MEB/PEB data, conditions that render a soldier to be not deployable or medically ready, performance limiting medications/conditions, Command Directed Evaluation results, LOD (mental soundness) determinations, and profiles.
What options are available for a postvention?
When a unit experiences something that could negatively impact it on an organizational level, our team can work with Commanders and Chaplains to assist the unit in processing the experience. Usually a traumatic event is the loss of a soldier, by accident, illness, or suicide. All of those generate a CCIR and once we receive the CCIR we will be reaching out to the POC listed for the unit to offer the event. We provide trained staff to come to the unit, usually on a battle assembly weekend, and present information that may help soldiers and the unit as a whole to understand what they are feeling and respond appropriately.
Will the Army Reserve pay for a SMs treatment?
That’s probably one of the most frequently asked questions. Access to behavioral health care is based upon eligibility, and eligibility is determined by military service. If the soldier’s behavioral health issue is service connected then yes, he may be able to get military sponsored treatment to address it. If the soldier is a veteran he may be able to access care at the VA. Many of our young soldiers do not have a service connection and have not had the opportunity to achieve veteran status, but we can still help the soldier get treatment within his community. If he has health insurance we’d start there. If he is uninsured then we will look at whether or not he qualifies for state sponsored insurance or free/low cost programs.
What about the WTU or Active Duty Medical Extension (ADME)?
Warrior Transition Units are designed to provide care and treatment to soldiers with service connected medical and mental health issues that require intensive treatment that would not permit the soldier to be able to work or meet other responsibilities. The soldier is placed on active duty orders and a treatment plan usually requires multiple appointments weekly. For information about this and many other things, you can go to the Warrior Care and Transition website at http://wct.army.mil/. Here, you will find information about med boards, disability, treatment options, and much more. It’s a treasure trove of information.
If a Soldier discloses behavioral health symptoms at battle assembly does that make it service connected since they are on duty when it started?
Not necessarily. If a soldier is at battle assembly and experiences symptoms of a behavioral health issue, the In Line of Duty (LOD) request can be submitted and it will be adjudicated here at USARC to determine the cause of the issue. For more information about LOD and Profiles, the Army Reserve Medical Management Center is the place to go: https://www.usar.army.mil/MedicalManagementCenter/
Many of the issues we experience are caused by stress and situations within our civilian lives and are not directly caused by an event or experience we’ve had while in a duty status. It’s a good idea to have realistic expectations about the entitlements for our soldiers. Many Commanders and units want to immediately put a soldier on orders for treatment, especially if that soldier is experiencing other issues, such as unemployment or homelessness. Without an approved LOD or established service connection there is no way to sustain a long term order for active duty for treatment, and it’s not always what is best for the soldier. Putting a soldier on orders for treatment sets up expectations that can lead to disappointment, frustration, and added stress because there is no mechanism for sustaining it over time.
The Psychological Health Program is in the initial stages of implementing a clinical case management program. Soldiers with more severe behavioral health issues will be enrolled in the program and assigned a case manager. Soldiers who generate a CCIR with suicidal thoughts or suicide attempts will automatically be enrolled. The case manager will reach out to the point of contact listed on the CCIR and introduce themselves to that Commander before contacting the soldier. The goal of case management is to ensure that soldiers with more severe issues do attend and engage in the treatment that will help them to get stronger and restore them to optimum fitness. We want to help our soldiers get healthy, ready, and be retained, and we want to keep Commanders informed about their progess.
We are your subject matter experts for behavioral health. If you require assistance with managing a soldier who has behavioral health issues, if you need information about profiles, med boards, evaluations, or anything else, please reach out to us. We will do our best to assist you to maintain a mentally fit and ready force.
USAR ACTING DIRECTOR OF PSYCHOLOGICAL HEALTH PROGRAM
CPT JOSH TIEGREEN Fort Bragg, N.C.
Stacey Feig, LPC Fort Belvoir, VA (OCAR)
63rd Readiness Division & 9th MSC
Meg Haycraft, LCSW
Amy Lindsey, Nurse Case Manager
Jill Robinson, Nurse Case Manager
81st Readiness Division & 1st MSC
Donna Brunetti, LPC, LPCC, LMHC
Kwajaleyn Myers, Nurse Case Manager
Sharon Harper, Nurse Case Manager
88th Readiness Division
Deb Olson, LCSW
Bruce Kyllonen, Nurse Case Manager
Martha Serbus, Nurse Case Manager
99th Readiness Division
Patricia Moloney, LCSW
Cindy Delphey, Nurse Case Manager
Maria Zelko, Nurse Case Manager
Army Reserve Medical Management Center (ARMMC)
Rhoda Donnelly, LCSW