JBSA-FORT SAM HOUSTON, Texas –
Many Soldiers throughout the Army have been on more than one deployment during their career. The stressors of being away from home and family, in addition to the change in living conditions and mission requirement can be a lot for many Soldiers to handle – both physically and mentally.
In an effort to help, Regional Health Command-Central, or RHC-C, at Joint Base San Antonio-Fort Sam Houston is increasing access and quality of mental health services through a virtual health program, formerly referred to telehealth.
Telebehavioral health, or TBH, is expanding mental health care for active duty Soldiers and their families by using video chat, or teleconferencing, in a clinical setting at RHC-C hospitals and clinics.
TBH is being utilized to support provider workload along with supporting clinics that may not have the ability to hire a specialist.
If military health facilities do not have an appointment available within a reasonable time frame, the patient will be asked if they would like to participate in TBH. If a patient needs to see a mental health provider with a specialization and one is not available at the military treatment facility, or MTF, the patient may also be referred to this program.
TBH is also being used to support overflow for walk-in hours at MTFs. Patients are able to request a teleconferencing visit rather than a face-to-face visit with a provider. Priority is given to active duty military.
The TBH appointment is held in a room adapted for teleconferencing at the designated MTF where the patient made the appointment or another MTF depending on individual circumstances. TBH appointments are only conducted at a MTF for the safety of the patient.
The TBH providers include 25 psychologists and psychiatrists based in San Antonio. Some of the remote providers have specializations. For instance, there is a child psychologist, child psychiatrist and aeromedical psychologist.
Remote providers have full privileges and are able to write prescriptions. These providers are also held to the same standards, policies, and procedures as providers at the MTFs.
Remote providers attempt to handle all areas of a patients care. If they are unable to perform a psychological exam due to being limited by the video conferencing, the MTF technicians perform the assessment and the provider interprets the results. All medical records and notes made can be easily accessed by both the remote provider and MTF; as well by any military health provider through the military’s universal record keeping system.
Patients are able to rate their satisfaction with the TBH appointments. According to Dr. Bruce Crow, clinical psychologist and director of the Warrior Resiliency Program, there have been no implications that TBH is less effective than face-to-face visits and patients have most often reported a very satisfied rating.
Administering mental health care through teleconferencing creates a unique atmosphere because “talking to a screen is somehow less intense or intimidating than talking face-to-face,” Crow said.
Certain fears of seeking mental health care are also diminished. “With TBH, there is a significant decrease in the possibility of running into your mental health provider in the community,” says Crow.
Crow also explained differences in the length of care for Soldiers versus civilians.
“Soldiers normally spend less time in therapy and are not able to complete therapy due to deployments, training, PCS and other duty requirements,” he said.
TBH makes it possible and efficient for Soldiers to prioritize and address their mental health care while maintaining duty obligations. A Soldier can be anywhere in the world and still continue their therapy with their trusted provider, according to Crow.
“There have been cases where Soldiers have requested and been able to finish treatment with a specific provider.”
TBH is developing and expanding. An app being developed will monitor and record health details such as “sleep patterns, mood, and journaling.” This app will be able to securely transfer information from a patient’s phone to the medical record for the provider to view.
This technology will enhance the care of the patient, record keeping, and symptom management. The app will be used in TBH and face-to-face mental health care.
TBH is just a small part of the Telehealth initiative. The initiative is about utilizing communication and medical technology to provide top quality general and specialty medical care to service members and their families anywhere in the world.
The Army has been making plans for TH since 1999 and started the program with teleconsultations for deployed troops in 2004, says TH project manager Chuck Lappan. TH programs are developing quickly and will revolutionize Army medicine.