Soldiers Deserve the Best Behavioral Care

PTSD screening program in military clinics identifying and treating more soldiers

(RxWiki News) As more and more troops return from conflicts overseas, more and more are at risk of developing post-traumatic stress disorder (PTSD) here at home.

A new military program being implemented across the nation hopes to ensure those soldiers' symptoms are recognized sooner so that they can be treated for the common but often stigmatized mental health condition.

"If you have any symptoms of PTSD, be sure to tell your primary care provider."

Col. Charles Engel, MD, MPH, director of the Department of Defense Deployment Health Clinical Center at Walter Reed National Military Medical Center and a senior scientist at the Center for the Study of Traumatic Stress, described the RESPECT-Mil program at a convention of psychiatrists last month.

As program director of RESPECT-Mil, Dr. Engel described how the program aims to identify and treat soldiers at risk for developing PTSD or depression sooner by screening them for mental and behavioral health at all primary care visits.

The RESPECT-Mil program, which stands for Re-Engineering Systems of Primary Care Treatment in the Military, began in 2007 and has helped identify and treat approximately 63,000 soldiers who had a previously undiagnosed behavioral health need.

These numbers add up to about 3 percent of all primary care visits, and the data presented for the period between August, 2009 and December, 2010 reveals significant reductions in the severity of PTSD symptoms among the soldiers.

While less than 10 percent had gone into remission with their symptoms before the program - dropping below the level of severity on a clinical PTSD checklist - Dr. Engel reported that more than 20 percent are now in remission.

The data also revealed a decrease in PTSD severity that correlated proportionally to an increase in visits to a care coordinator: the more a patient met with a caregiver for any form of therapy, the better he or she gradually became.

RESPECT-Mil is used in in 88 of the Army's 96 primary clinics across the world, with approximately 100,000 screenings conducted each month. The steps followed by the clinics and the care coordinators are standardized throughout the program, including making the soldiers with the most severe symptoms a higher priority.

"Making behavioral health screening as standard as a blood pressure check helps defuse any perceived stigma around seeking help for symptoms of PTSD or depression," Dr. Engel said.

"Early intervention ensures soldiers get effective help sooner while reducing the use of clinical services for related symptoms like back pain or accidents and emergency room visits from hazardous drinking," he said.

Eighteen of the RESPECT-Mil clinics are currently a part of a five-year randomized, controlled trial to compare different approaches for possible changes or improvements to the program.

The program was described at the American Psychiatric Association's annual meeting in May.

Review Date: 
June 11, 2012