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101st Airborne vastly expands care for 'unseen wounds'

Apr. 30, 2013 - 06:00AM   |  
The staff of the 1st Brigade Combat Team Embedded Behavioral Health facility celebrated a milestone for Fort Campbell and the 101st Airborne Division on April 29, as five clinics were officially opened on post to deal with problems such as PTSD and soldier suicides.
The staff of the 1st Brigade Combat Team Embedded Behavioral Health facility celebrated a milestone for Fort Campbell and the 101st Airborne Division on April 29, as five clinics were officially opened on post to deal with problems such as PTSD and soldier suicides. (Philip Grey /The (Clarksville, Tenn.) Leaf-Chronic)
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FORT CAMPBELL, KY. — Not so long ago, there were only five psychiatrists and one treatment facility dealing with PTSD, depression and other behavioral health issues for Fort Campbell’s 30,000-plus soldier population.

That capacity has just been increased many times over, with the opening of no less than five newly-constructed and staffed Embedded Behavioral Health Care Team facilities – one for each of the 101st Airborne Division’s four brigade combat teams and another for the 101st Sustainment Brigade. Additional psychological health support has also been added to each of the division’s two combat aviation brigades.

Open houses were held at the new facilities on Monday, as post officials celebrated the milestone, achieved just one year after the first pilot program at the 4th Brigade Combat Team was announced by Maj. Gen. James C. McConville, Commander, 101st Airborne Division and Col. Paul R. Cordts, Commander, Blanchfield Army Community Hospital (BACH.)

Attending the ribbon-cutting for the new permanent 4th Brigade Combat Team facility in place of McConville, currently deployed in Afghanistan, was acting senior commander Brig. Gen. Mark R. Stammer.

“We wanted Brig. Gen. Stammer to see and know the power of what we’ve set up,” Cordts said.

Genesis

What the medical community of Fort Campbell has set up is a means of reaching a much greater population of soldiers, while greatly increasing the amount of care for those soldiers.

Post officials credit Fort Carson, Colo. for the idea of embedding behavioral health teams where soldiers work and live.

Fort Carson’s program began in 2009. When McConville arrived to command the 101st Airborne in 2011, he was coming off an assignment at the Pentagon working with Gen. Peter Chiarelli on the “Gold Book,” a frank and disturbing look at the Army’s PTSD and suicide problems.

McConville borrowed from Fort Carson’s playbook to expand the battle against those issues at Fort Campbell.

Monthly to weekly

Psychiatrist Maj. Bonnie Huber, 1st Brigade Combat Team Chief of Embedded Behavioral Health (EBH,) said that the change to a decentralized model has been a huge leap forward in the ability to treat soldiers.

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“Before,” she said, “there were never enough providers, and it was hard to talk to and coordinate with commanders.

“We were able to treat the soldiers we could access maybe once a month. Now we can treat weekly.”

Each facility, when fully staffed, has 13 members, including a psychiatrist, three psychologists, three behavioral health licensed clinical social workers (LCSWs,) a nurse case worker and other staff.

The BACH emergency room, staffed with an LCSW, fills in on weekends and nights and a psychiatrist is always on call.

Huber said full staffing throughout the division is still a problem due to budget cuts. However, the numbers bear out the need for the program.

Since the 1st Brigade facility first opened its doors in Sept. 2012, the team has had over 3,000 outpatient visits from hundreds of soldiers.

Still, stigma is a problem, especially among career-minded soldiers, though Huber said that high-functioning leaders coming forward with their own problems is helping to break the hold.

“The belief before was that only ‘broken soldiers’ sought help, that you only went if you were ‘that guy.’”

Success equals clients

1st Brigade Behavioral Health Officer Capt. Jazz Irizarry said that ease of access and a more welcoming atmosphere makes it easier for soldiers seeking help, particularly younger soldiers with transportation issues.

The personal connection of seeing Irizarry every day in the brigade area also makes it easier for soldiers to approach her with problems.

“Going to events, providing services, doing PT (physical training) with them,” she explained. “It’s about building rapport out there and then coming back here.

“And it’s not just the younger soldiers,” she added. “We get the whole spectrum, 18 to 45 (years of age).

“Before EBH, it was hard to communicate with patients and fellow providers. It’s so easy now to just go down the hall. Now I know my clients, their behavior, their medication, what they’re doing. I can treat weekly if needed, or more usually, once every two weeks. With the centralized system, you saw a patient maybe once a month, a month and a half.”

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So how do providers measure success?

“I have had wives come up to me with tears in their eyes telling me, ‘I don’t know what you’re doing, but thank you,’” Irizarry said.

“The goal is getting rid of stigma. Success equals the amount of clients coming in.”

Involved up front

“I didn’t even know I had an embed behavioral health team when I became ‘Rear D’ commander,” sid Lt. Col. Joel Hamby, rear detachment brigade commander for the 4th Brigade Combat Team, “but I’m really pleased I have one.

“It really helps soldiers and there’s no fighting bureaucracy.”

“The decentralized model is just more effective.” Cordts added. “Commanders often had misunderstandings when soldiers came out of an in-patient facility.

“The policy now is, the day a patient is released from the hospital, they are seen at this clinic, with someone in the soldier’s chain of command. From Day 1 there is a firm understanding of the plan of care.”

“Also, the EBH teams meet new soldiers when they come into the brigade. The teams are involved from the beginning, at the front end.”

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