DoD Officials Develop New Psychological Policy Initiatives

by U.S. Medicine

March 10, 2011

WASHINGTON, DC—DoD officials are developing new psychological health initiatives that they hope will fill gaps in delivering and coordinating psychological care.

One initiative in development will bolster disaster mental health assistance on installations after an emergency event by requiring that military installations be equipped with a disaster response mental health team.

DoD’s ability to respond to internal threats came under scrutiny as a result of the November 2009 shootings at Fort Hood. The department commissioned an independent review after the incident which identified gaps and deficiencies in dealing with internal threats.

One of the findings of the report was that DoD installations have not consistently planned for mental health support for victims and their families after domestic mass casualty incidents. “We had a gap at the DoD level in terms of policy for post disaster mental health response,” said Lt Cdr Nicole Frazer, PhD, USPHS. “We have been directed to fill that gap.” Frazer is a senior policy analyst in DoD’s Force Health Protection and Readiness Office, and was speaking at the 2011 MHS conference.

Disaster Response Mental Health Teams

Frazer said that they examined what was already in place related to emergency preparedness and response policy within DoD and other agencies. The new initiative would require each installation to have access to a trained multidisciplinary disaster mental health response team. The team would include individuals trained in areas like mental health, spiritual support, and family support and would be led by a mental health provider.

The team’s work would entail helping individuals or groups in the aftermath of an all hazards incident, including not only natural disasters, but human caused incidents like shootings, accidents, or even suicides.

Teams would be trained in prevention, screening, psychological first aid, outreach, and triage, among others things. They would train quarterly and also train as part of the annual emergency installation management exercises. “[If] that disaster mental health team is integrated into the entire installation emergency management response, then you have the conditions under which you can promote access to care, get people the care that they need, and develop a culture of preparedness,” said Frazer.

Directors of Psychological Health Policy

Officials are also working on an initiative that would establish directors of psychological health policy at DoD at service and installation levels.

The 2007 DoD Task Force on Mental Health Report found that there are different mental health services and programs offered at installations, such as family services, medical services, and religious programs, but that there were “various degrees of segregation of these programs and no consistent plan for collaboration in promoting the psychological health of servicemembers and their families.” The report noted that “the services are stovepiped at the installation and service levels.”

The task force recommended that services should ensure that each military treatment facility has a director of psychological health (DPH) who serves as the installation commander’s consultant and has the authority to convene meetings of all resources on the installation that support psychological health. In addition, there should also be service-level DPHs.

The report also recommended that a DoD psychological health council should be established consisting of the active duty, National Guard, and Reserve directors of psychological health and other senior leaders as appropriate to develop a DoD vision and strategic plan for supporting the psychological health of servicemembers and their families.

While some may wonder why there would be a need for DPH policy since psychological health resources have gained more visibility since 2007, a more recent 2010 suicide prevention report still found that most installations lacked a unifying office for installation support services, according to John Davidson, PhD, a senior policy analyst in DoD’s Force Health Protection and Readiness Office. “They also found that agencies remained mostly independent and confusing in the eyes of servicemembers,” said Davidson. “In other words, these resources are still stovepiped.”

According to the draft of the DPH policy, the installation-level DPH would report to senior line leadership. The DPH’s job would primarily be resource integration and coordination. The service level DPH’s responsibilities would be to formulate and implement the strategic planning for psychological health and to communicate best practices to the installation-level DPH, among other things.

The draft policy charges a psychological health council with institutionalizing a culture and structure to promote psychological health, examining the factors that stress the force, and developing a standard set of indicators for measuring psychological well being and providing policy recommendations.

Davidson said that the National Guard already has a DPH in every state and territory, and the Air Force has also set up its DPH policy establishing senior military mental officers as DPHs.

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