Non-Clinical Topics   /   TBI

New Training Guides Medical Personnel in Administering Mental Health Assessments

USM By U.S. Medicine
November 14, 2010

WASHINGTON, DC—DoD is providing new online training to its medical personnel for administering deployment mental health assessments to deploying and returning servicemembers.

The revamped mental health assessments focus on PTSD, depression, and substance abuse problems. Officials hope that they will be able to better catch mental health issues in servicemembers prior and after deployment, according to Air Force Lt Col Hans Ritschard, PhD, director of the Psychological Health Strategic Operations Directorate for DoD’s Force Health Protection and Readiness Program. “We want to check to ensure before deployment [that} there are no outstanding mental health concerns that have not been addressed. Similarly, when they come back we want to ensure that we identify servicemembers who may have mental health concerns after their deployment.”

The new mental health assessments will be followed by a clinical interview mandated by law between the servicemember and either a licensed mental health professional or a trained and certified healthcare provider.

DoD medical providers who are not licensed mental health professionals can take a new online training course and test to become certified in delivering the new person-to-person mental health assessments. The training is available at http://fhp.osd.mil/mentalhealthassessment or http://fhp.osd.mil/mha. “Because the new mental health assessments are so involved, and since they require a person-to-person
interaction, we thought it was extremely important to train specifically for the task of completing these mental health assessments,” said Ritschard.

Mental Health Assessments

The 2010 National Defense Authorization Act requires that deployment mental health assessments be administered to servicemembers within two months before the estimated date of their deployment; between three to six months after they return from deployment; between seven to 12 months after they return from deployment; and between 16 and 24 months after returning from deployment.

Ritschard explained that the new assessments are “significantly different” than the assessments used in the past.

Previously, the Pre-Deployment Health Assessment (Pre-DHA) was given 60 days before deployment, and primarily focused on physical concerns. Now, in addition to addressing physical concerns, both the Pre-DHA and the Post-Deployment Health Reassessment (PDHRA), which is given three to six months after deployment, include comprehensive mental health assessments that ask questions specifically assessing PTSD, depressive symptoms, risky alcohol use, and other mental health concerns.

In addition, mental health assessments will now be given 12 months and 24 months following a servicemember’s return from a deployment. While DoD has had an annual periodic health assessment in place for servicemembers, previously there was no specific mental health assessment as part of this.

The only DoD assessment that will not change is the Post-Deployment Health Assessment, which occurs within 30 days before or after a servicemember’s actual return from deployment.

Training for Assessments

One important focus of the new online training will be on the clinical interview between the provider and servicemember. During this interview, the servicemember will be asked about the answers he or she gave on the assessment. The interview can be done via telephone, via video telehealth link, or face-to-face.

Ritschard said that studies have shown that there may be a tendency on the part of clinicians to spend more time following up on physical concerns than emotional concerns, so they want providers to be “sensitive to any tendency that they have to spend less time on mental health concerns.” The training will target effective motivational interviewing techniques, “so that a climate of trust and confidence is fostered” and servicemembers feel free to discuss any mental health concerns they may have, Ritschard explained.

For certification after completing training, Ritschard said that the provider “must show mastery of the material.” The post-training test and certificate were expected to be added online by the middle of October.

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