FALLS CHURCH, Va. —
Air Force mental health leaders have implemented a new initiative at nearly all Air Force bases to improve access to mental health, increase access to support resources and mitigate the impact on readiness.
For more than a year, the Air Force Medical Service has introduced Targeted Mental Health Care, an initiative that helps Airmen and caregivers understand all available support options and connects them to the right resource, either at a mental health clinic or outside of a military medical facility with another support agency that best meets their needs.
“Mental health across the nation is a limited resource, and we need a solution that ensures we’re connecting people to the optimal counseling resource, and that’s not always going to be at the mental health clinic,” said Lt. Col. Aaron Trich, clinical psychologist and head of the Air Force’s targeted mental health care. “Many of the concerns we see are subclinical or not something we would diagnose and treat in the clinic, such as homesickness, momentary problems at work or relationship problems. They cause stress and need to be looked after, but they can be better supported outside the clinic.’
Through targeted mental health care, providers direct patients to the resources they need to address their specific issues. If the mental health technician determines that specialty care does not best meet the patient’s needs, staff refer the patient to a support agency such as Primary Care Behavioral Health, group therapy, Family Advocacy, a domestic violence advocate, Military OneSource, a chaplain, a Military and family life counselors, the Alcohol and Drug Abuse Prevention and Treatment Service, among others.
This vectoring approach allows medical staff to provide immediate attention to those whose problems need to be addressed by a mental health provider, while connecting others whose needs are important but may not require clinical services and can be referred to an auxiliary agency to receive timely care. According to Tritch, this approach has helped reduce wait times for immediate and follow-up care.
“For years, the Air Force has encouraged its members to go to mental health care when they’re in trouble, and that’s great. However, increased demand has left us unable to see patients as often as we need to,” said Maj. Amanda Kruszewski, mental health flight commander with the 31st Health Operations Squadron, Aviano AFB, Italy. “Meanwhile, we have multiplied additional resources to support mental health, such as operational support teams, True North and primary behavioral health care. In addition, the mental health clinic has opened several evidence-based treatment groups that have benefited patients and opened up access to one-on-one appointments.”
Targeted mental health care also helps with the readiness of airmen and custodians. For those who require specialist mental health care, the reduction in initial waiting times and time between appointments supported by targeted mental health care ensures that patients receive care at the right time and minimizes the time before to be able to return to work.
“There are members who seek care because they are experiencing some depressive and anxiety symptoms, but they don’t necessarily meet the threshold for specific mental health treatment,” said Capt. Amy Dixon, mental health officer in charge of the 60th Operations Squadron. medical readiness, Travis Air Force Base, California. “Because [Mental Health Targeted Care], those who need to be seen by one of our mental health diagnostic clinic providers will receive consistent care. This allows us to better assess how the treatment is working for them and make any necessary adjustments to best support them.
Trich also explained that this relationship with the range of support resources on the base keeps Air Force Chief Master Sgt. Spectrum of resistancewhich emphasizes a holistic approach to help-seeking, including building personal resilience skills, connecting with friends and family, and reaching out to non-clinical support organizations.
“There is a continuum of resources on base focused on mental health,” Trich said. “Mental health providers work with these resources if members need to be connected to us. In essence, we have a care system that wraps around the individual wherever they go, reducing the time between when they need care and when they receive it.”
“Because I see patients more often, patients experience faster resolution of symptoms. All the vendors here care deeply about what they do and who they serve. There is a palpable rise in tension as they are able to provide the best care. Watching them thrive as they see their patients improve has been a gift. This initiative is a huge step in the right direction.”
– Maj. Amanda Kruszewski, Mental Health Flight Commander, 31st Health Operations Squadron
From the airman’s or guardian’s perspective, nothing changes through this initiative, only the process of deciding where and how they will receive the best support and care. It still begins with the individual walking into or calling the mental health clinic. From there, a mental health technician will go through what Trich explained as a vectoring and sorting process.
“Our technicians will talk with the member, go through a series of questions, and determine, in consultation with a mental health provider, whether their concerns would be best addressed in the clinic or through other non-medical counseling services,” Trich said. “If that Airman or guardian has been referred to a non-clinical resource and they don’t feel comfortable with that choice, then they can still ask to see a mental health provider.”
The pilot phase of Targeted Mental Health Care ended in the summer of 2022 after a year-long evaluation of the initiative at nine bases. Initial feedback from these pilot sites was positive, with them finding that 51% of members contacted had needs that were better met by other care agencies and were connected to these resources, ensuring that they received the immediate support they needed.
“We also found that we had more than 2,000 mental health appointments that became available to members who needed special mental health care,” Trich said. “We’ve seen across the board that we’ve been able to treat patients sooner, respond to command needs faster, maintain readiness and get patients with more acute problems the treatment they need and with the frequency they need.” need.”
Similar successes, such as reduced wait times for admission and time between appointments, are already evident as the initiative continues to roll out. At Aviano, mental health providers have witnessed an improved overall experience among the airmen they support.
“I’ve seen these changes revolutionize my own practice,” Kruszewski said. “Because I see patients more often, patients experience faster resolution of symptoms. All the vendors here care deeply about what they do and who they serve. There is a palpable rise in tension as they are able to provide the best care. Watching them thrive as they see their patients improve has been a gift. This initiative is a huge step in the right direction.”
The Targeted Mental Health Initiative is currently spread over three phases across the Air Force. In addition, the Defense Health Agency is adapting the Air Force’s Targeted Mental Health Care Initiative and developing its own pilot project at 10 Army and Navy installations to help improve access to care for all service members.