By CPT Cory Gerould
SPC Jeffrey Villar (seated), a Behavioral Health Specialist with the 204th Brigade Support Battalion, 2nd Brigade Combat Team, 4th Infantry Division, speaks with a Soldier from a distant location on the telebehavioral health (TBH) system at Forward Operating Base Walton, Afghanistan, in November. TBH provides real-time videoconferencing and an atmosphere similar to that of face-to-face interactions in a more traditional setting. (Photo by CPT Cory Gerould.)
As the brigade psychologist for the 2nd Brigade Combat Team, 4th Infantry Division, using telebehavioral health (TBH) to conduct consultations has significantly increased my ability to provide services to a greater number of Soldiers more efficiently and quickly. Additionally, TBH has helped reduce some of the challenges that arise in connecting Soldiers with health providers downrange.
Commanders cannot always readily determine when a Soldier may need behavioral health services, particularly when a Soldier denies having problems or is not ready to ask for help. Taking a Soldier out of the fight for several days would have considerable impact on the mission, not to mention the logistical challenge it would place on the platoon.
TBH provides for real-time videoconferencing and grants an atmosphere similar to that of the face-to-face interactions in more traditional settings. As a result, the Soldier doesn’t need to be moved or be held back from going on a mission to meet with an incoming provider, which enables units to maintain their combat strength.
When the Soldier in need is not co-located with a TBH system, evaluations and follow-up services are easily coordinated around the unit’s schedule, supporting both the unit and the Soldier.
While there have been a few minor growing pains in establishing the TBH systems, the benefits continue to be realized regularly. I have found that TBH greatly bridges the gap in accessibility and allows me to quickly assist commanders in constrained situations.
When I meet with a Soldier via TBH, at the outset of the interaction I make it a point to explain the nature of the TBH system, including the potential limitations in connectivity. I also make sure I obtain the Soldier’s consent to proceed with receiving behavioral health services via TBH during the first interaction.
Taking the time to do this helps the Soldier feel more comfortable and provides an opportunity to discuss any concerns he or she might have with using this system. This further engages the Soldier in the process and starts facilitating a therapeutic relationship.
Terrain and decentralized operations have made it quite a challenge to move Soldiers or health care providers to outlying locations. TBH has proven to be a reliable and effective platform for increasing access to behavioral health providers despite these factors.
This article first appeared on http://www.mc4.army.mil/blogs/Field_Blog/October/2011#Telebehavioral_Health_Improves_Combat_Strength, a blog of the Medical Communications for Combat Casualty Care Program, within Program Executive Office Enterprise Information Systems.
CPT CORY GEROULD is a Brigade Psychologist with Regional Command – South, Afghanistan.
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