Congress Eyeing Funding Support for Military MH Program

By Valerie Canady
December 19, 2011

Congress last week passed a defense authorization bill that includes among its many provisions funding support for a military mental health program for National Guard and Reserves units. That provision in the $662 billion legislation had received attention from mental health advocates who pushed for funding following opposition for the program from Department of Defense officials.

The Pentagon had urged Congress not to create a mental health program for National Guard soldiers, noting that the program would be difficult to staff during a time when mental health providers are in short supply nationally, according to a Defense Department position paper cited in USA Today.

Before Congress passed the legislation, the National Alliance on Mental Illness (NAMI) had released a statement to Congress noting that the mental health crisis in the National Guard soldiers is at stake in the U.S. Department of Defense Appropriations bill.

“Pentagon data reports that more National Guard troops have died from suicide each of the past five years than were killed in combat or died of accidents or illness in Iraq and Afghanistan,” NAMI executive director Michael Fitzpatrick said in a statement.

The mental health program cited in the Defense bill would embed mental health counselors in Guard and Reserve units. The mental health professionals would encourage soldiers to seek mental health services when they need them, said Fitzpatrick, who cited a similar program available for active-duty units.

Andrew Sperling, director of federal legislative advocacy for NAMI, said he suspects, but can’t confirm that maybe the Defense Department’s reason for opposing funding for the mental health program may have to do with an inability to find an adequate number of mental health counselors to provide the services within FY 2012.

“NAMI’s position is that they need to come up with a workable solution,” said Sperling. Funding support needs to be provided to National and State Guard units for mental health services. “There is a huge need for young men and women in the military [especially those] who are most at risk for suicide,” Sperling told MHW.

When national and state National Guard members return, they often return to their community or to jobs with little or no support, he said. “In general, they’re not showing up in the VA hospitals,” he said.

Pilot program

The Defense bill includes funding for a mental health program to be made available to state and National Guard units around the country. The Embedded Provider Program, a pilot program in California is receiving attention for its work with soldiers around the state. The program provides outreach support for National Guard and Reserve members who may not have access to the support and resources found in active duty military communities, said program officials.

TriWest’s Embedded Provider pilot program has supported 26 licensed behavioral health counselors embedded with 39 California National Guard units. The counselors refer service members out into the community for additional behavioral health treatment.

These counselors provide support and referral assistance during drill weekends and family readiness events, said Scott Celley, vice president of external affairs for TriWest Health Alliance, a contractor with Tricare, the state’s military health plan. It costs TriWest about $500,000 annually to fund the program, he said.

According to a July 11 report from the California National Guard, the percentage of soldiers seeking counseling who self-referred increased from 36 percent to 57 percent, since the program’s implementation in 2006.

Over that same time period, more than 16,000 soldiers have sought individual service and over 19,000 have participated in nearly 900 related group therapy discussions, according to the report. In addition, the providers have referred more than 1,200 cases out for ongoing treatment as those men and women return to their communities.

The referrals represent approximately 7 percent of the total patient interactions, according to an assessment of the program in July. However, that number has been declining since the start of the program in 2006 when nearly 12 percent of interactions resulted in the need for more serious, follow-up clinical care, said officials. The data suggests that easily available, early intervention can stem the need for more serious treatment in the long run, they said.

“We have a robust behavioral health network that serves our military members,” Celley told MHW. Providers include psychologists, social workers and family therapists, he said. When Guard units are brought together for drilling purposes, providers are available and in attendance to support and assist Guard members, he said.

“The legislation represents the furthest we’ve advanced in securing funding for the program,” Colonel Darc Keller, assistant state surgeon for the California Army National Guard, told MHW. The program employs clinicians in 20 percent of the National Guard’s facilities with exposure to about 23 percent of the soldiers in the state, he said.

Military officials developed criteria to identify high-risk units, particularly soldiers in multiple warrior units and those facing high-risk deployments, he said. The Pentagon opposed the program noting that it’s probably not necessary in all of the states, he added.

UCLA and the University of Southern California plan to work with National Guard members to help them with reintegration and coping skills, said Keller.

Keller said he is pleased that Congress supports funding to expand this program to other states. Part of the program’s success story is the reduction of stigma associated with seeking mental health services, he said. “One of the most successful elements is that [National Guard and Reserve members] see the value in seeking help,” said Keller.

MH professionals training to treat MH needs of returning veterans

A major research university is helping to address the critical workforce shortage of mental health professionals trained to address the mental health needs of returning veterans by offering students a master’s degree in social work with a specialization in military social work and veteran services.

The program commenced at the University of Southern California School of Social Work with 25 students. As troops return home, the growing need to address the mental health needs is just as important as addressing the critical workforce shortage, said program officials. The program has since grown this year to 105 students said Paul Maiden, Ph.D., vice dean and professor at the School of Social Work at the University of Southern California.

“We’re the first research university in the country that offers graduate degrees in military social work,” Maiden told MHW. The U.S. Army has a similar program in San Antonio and Houston but its program is limited to enlisted personnel, he said.

Southern California program officials point to a policy brief by the Center for a New American Security, an independent and nonpartisan research institute. The brief, “Losing the Battle: The Challenge of Military Suicide,” released in October, highlights the shortages of mental health professionals to support both active duty troops and veterans. According to the brief, the Army has only filled only 80 percent of its psychiatrist positions and 88 percent of its social work and behavioral health nurse jobs.

The University of Southern California School of Social Work has academic centers in Los Angeles, and San Diego and last year introduced a virtual academic center, a web-based MSW programs for students, said Maiden. Graduates of the program have gone on to work with the Veterans Administration (VA), on military bases and with homeless programs for veterans.

For more information, visit www.usc.edu\socialwork.

Please see the original article here.