The 359th Medical Group at Joint Base San Antonio-Randolph
offers beneficiaries comprehensive medical care, dental care and physical
therapy in one location, but it also provides patients with a service that
helps them improve their mental and emotional well-being.
The Internal Behavioral Health Consultation Service, which
is part of overall health care at the medical treatment facility, helps
beneficiaries when their habits, behaviors, stress or emotional concerns about
their physical issues or other problems interfere with their daily lives.
“We offer support services to primary care managers,
providing brief intervention in any area of behavioral health,” said Jennifer
Mitchell, 359th Medical Operations Squadron behavioral health consultant. “We
teach classes and offer consultation and education to patients and providers.”
Mitchell, who is a licensed psychologist, said she and the
359th MDOS’ other behavioral health consultant, licensed clinical social worker
Marcia Blake, see patients if PCMs from the medical group’s clinics feel a
consultation is necessary or would be beneficial.
“We take referrals from all the clinics,” she said. “We
support what the primary care manager is doing. We offer solution-focused
intervention.”
A consultation may be seen as the first step for those who
are experiencing behavioral health issues, but it is often the only step that
is necessary, Mitchell said.
“Our patients are provided up to four appointments, which
last about 30 minutes each,” she said. “We can be a gateway to more services,
but often this is all that is needed. If more intensive counseling is needed,
we refer them to the mental health clinic, a military and family life
counselor, Military OneSource, the chaplain’s office or another resource.”
Behavioral health consultants, or BHCs, help patients manage
chronic pain, depression, grief and anxiety and can provide brief intervention
on post-traumatic stress disorder, Mitchell said. They can also assist people
with sleep problems and help reduce symptoms associated with conditions such as
migraines and other headaches, diabetes, asthma, hypertension and irritable
bowel syndrome and help people cope better with these conditions.
“We provide early intervention so people won’t develop more
severe problems,” she said. “We help people lead productive lives and reduce
the impact of their health problems.”
Mitchell said the work of BHCs complements the duties of
primary care managers and other MTF team members, playing an important role in
the MTF’s collaborative approach to total health care.
“We can work as a team deciding what’s best for the
patient,” she said.
Mitchell said BHCs provide support for the behavioral
components of anything the PCMs treat.
“We teach a lot of stress management, relaxation exercises
and goal-setting,” she said. “We identify barriers to improvement, help with
problem-solving and time management, teach mindfulness skills and help people
identify and challenge unhealthy thinking patterns.”
BHCs can also help patients with lifestyle modifications to
address issues such as smoking, alcohol use and other unhealthy habits and
behaviors.
Mitchell sees the cross-section of MTF beneficiaries:
active-duty members and their family members as well as retirees. She said
children need help adjusting to illnesses such as asthma and diabetes and
dealing with eating problems, anxiety, emotional stress and life’s transitions.
“I usually see one to two children a day,” she said. “It’s
part of their primary care service.”
Another member of the Internal Behavioral Health
Consultation Service at the 359th MDG is Christine Morgan, a nurse who serves
as a behavioral health care facilitator.
“When patients start on a new medication, she follows them
to see how it’s working,” Mitchell said. “She’ll stay in contact with a patient
for four to six months. It’s a unique service the military offers.”
The work of BHCs differs from that of specialty mental
health services in a few ways, Mitchell said.
For one thing, BHCs do not provide traditional
psychotherapy, she said.
“We have shorter appointments and we treat a wider variety
of problems than a specialty mental health practitioner would,” Mitchell said.
Documentation is another difference.
Assessment and recommendations from the BHC are written in
the outpatient medical record; a separate mental health record is not
maintained.
Mitchell, who typically sees seven to 10 patients each day,
said that being part of the primary care clinic allows quick intervention.
“We can catch the problem and intervene quickly,” she said.
“It’s easy access to help. It’s convenient and comfortable for the patient.”
Every day is different and exciting for BHCs, Mitchell said.
“On any given day, I may teach a class, see somebody for
stress or a couple for marriage intervention, help someone with an alcohol
problem or provide a post-traumatic stress disorder intervention,” she said.
BHCs want to help patients return to good quality of life,
Mitchell said.
“We want to catch their problems early and give them the
tools they need,” she said. “If any problem is interfering with their daily
lives, we want to help.”