Rising Suicides Stump Military Leaders

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'Telehealth' a Promising Area of Treatment

"Marines, when we call a number, if we get a social worker or someone, they're going to know it's not a Marine. But when there's a Marine there or someone that talks Marine, then they'll open up," he said, referring to a call center run "by Marines for Marines."

Military leaders say such "telehealth" programs -- treatment over the phone or Internet video chat -- are especially promising because they allow mental health professionals to reach service members stationed in remote or rural areas who might not have access to a health care facilities.

"There is an imbalance between where the people who need services live, and where the people who provide psychological help are located," said Dr. Jamie Adler, chief of clinical telehealth of the National Center for Telehealth and Technology (T2).

Alder said telehealth is especially useful when providers are temporarily overwhelmed by the numbers of people they need to help, such as after a deployment.

"When service members come home after deployment, they come in large groups, and are supposed to come do screenings," Adler said in an interview. "A lot of facilities they come back to don't have enough personnel to do face-to-face screenings."

To mitigate this, Adler said, some facilities will set up individual sound booths in a gymnasium, for instance, to allow professionals from a variety of different areas to dial in, and meet the "surge of need" to do these mental health screenings.

Adler said a number of studies that have looked at the comparison between service provided via video chat and face to face show that the outcomes tend to be about the same.

Dr. Mark Reger, T2 deputy director and leader of its suicide research team, said smartphone apps fall within the scope of telehealth.

"Many soldiers or warriors have a smartphone in their pocket 24/7," he said. "It's a tool where we can reach them where they are, whenever they need services."

He said there are apps related to common breathing tools that coach individuals with symptoms of post-traumatic stress disorder or mild traumatic brain injury, or link them to Web resources.

Telehealth also makes receiving mental health care more discreet.

"What we found is, if you have an alcohol problem, you probably don't want to run to your squad leader and tell him about it," Bostick said at the hearing.

"We're finding some great success in the virtual world with tele-behavioral health," he said, "Where we're able to allow the individual to talk virtually to some of these behavioral health specialists and have the privacy but get the care that they need."

Telehealth programs could be especially helpful for veterans or inactive reservists who are geographically removed from the support network provided by military installations, and have limited access or reduce access to health care and the oversight of a full-time chain of command.

"We've partnered with the Department of Vet Affairs to address the issue of reserve component service members in rural areas by really enhancing the whole concept of tele-behavioral health," Bostick testified.

"And this is a very interesting concept which will allow, via Internet connection, for someone who might be in crisis or have a problem to talk directly with a behavioral health specialist and get care. And preliminary results suggest that it's a very acceptable means to provide care."

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