Behavioral Health Provider Training for Post-Deployment

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Behavioral Health Provider Training for Post-Deployment

Transcript Of Behavioral Health Provider Training for Post-Deployment

Behavioral Health Provider Training for Post-Deployment Health Reassessment
For military service members who have returned from deployment
© 2007 Magellan Health Services This information is confidential and the proprietary information of Magellan.

Introduction PDHRA Overview
Provider Qualifications Do I Qualify? Contact Information
Military Culture Overview of the U.S. Military Ranks and Insignias – Enlisted Ranks and Insignias- Officer
The Day of the On-site PDHRA Dress Code Arrival Time Set Up Formation Flexibility Self-care
Battlemind Presentation Purpose Internet Resources DD Form 2900
Behavioral Health Assessment When Necessary? Process Documentation Imminent Health Risk Documentation Examples Referral Resources
Roles PDHRA Team Relationships
Conference Call with LHI and PDHRA Team Travel and Reimbursement Procedures
Lodging Travel Reimbursement Contacts After-Action Report Additional Resources Provider Pre-Screening Frequently Asked Questions Glossary of Terms Web Sites
© 2007 Magellan Health Services This information is confidential and the proprietary information of Magellan.

Behavioral Health Provider Training for Post-Deployment Health Reassessment (PDHRA)
Introduction: The Post-Deployment Health Reassessment (PDHRA)
The PDHRA is part of a program offered to all military service members in the Army, Air Force, Marines, and Navy, including the Reserve, National Guard, and Active Duty, who have returned from operational deployment (e.g., war in Iraq or Afghanistan). The PDHRA is designed to identify and address physical and mental health concerns that have emerged since deployment. It provides education, screening, and a global health assessment to identify and facilitate access to care for deployment-related and readjustment concerns.
The PDHRA is generally scheduled to take place within 90 to 180 days after the service member has returned home. While all members are assessed immediately at the end of deployment through a Post-Deployment Health Assessment (PDHA), not all health concerns will present at this single point in time. Readjustment issues may not emerge until the member re-enters their work and family environment. Consequently, the Department of Defense (DoD) developed the PDHRA – a second post-deployment assessment – as an additional component to its health care initiatives and part of the Force Health Protection and Readiness program.
The PDHRA includes a 30- to 45-minute slide or video presentation, titled “Battlemind Training,” that is presented by a behavioral health specialist; this is then followed by the completion of government form DD Form 2900. The form is usually completed in an electronic or Web-based format and is used to document health concerns, assessment findings, and referrals. Once the form is completed by the service member, a health care provider discusses with the member any health concerns that he/she has indicated on the form. If the service member needs further evaluation or treatment, the provider makes recommendations to appropriate health care or community-based services.
The PDHRA team members typically include one to two physician assistants, one to two administrative staff, a nurse, and a behavioral health specialist.
Magellan’s goal for the PDHRA is to maximize the power of our behavioral health expertise to support our service members at a most-sensitive time in their lives. While showing them the respect and dignity they deserve, we want to offer support and solution-focused resources in order to improve health care outcomes and positively influence their total health and well-being.
© 2007 Magellan Health Services This information is confidential and the proprietary information of Magellan.

Behavioral Health Provider Training for Post-Deployment Health Reassessment (PDHRA)
PDHRA Behavioral Health Affiliate Qualifications
Do I Qualify? ƒ Affiliates must be at least master’s-level and possess an active license(s) in the behavioral health field in the state in which the on-site services are being held. ƒ Affiliates must familiarize themselves with all the materials available in this training and provided to them by Logistics Health Incorporated (LHI). ƒ Affiliates must be flexible (due to the frequent changes, last-minute information, possible on-site time extensions, etc.). ƒ Affiliates must have an independent/self-starter type of personality. ƒ Affiliates must be team players and have a willingness to perform tasks outside the normal scope of job duties in order to maintain the efficiency of the PDHRA event. ƒ Affiliates must have an understanding and acceptance of the military version of confidentiality and also the general military culture in which they will be working. ƒ Affiliates must have basic computer knowledge and ability to quickly learn to operate computerized tablets.
I Qualify! Whom Should I Contact? ƒ If you are interested in participating in a PDHRA event as a behavioral health affiliate, please contact one of the following people at Magellan Health Services:
o Angie Ruppel – 1-877-326-7525, ext. 72246 o Magellan Workplace Support – 1-800-997-2273
Magellan representatives can review the PDHRA event with you and answer any further questions you may have. They will also add you to the network of providers utilized for the PDHRA events. ƒ Once a PDHRA event is scheduled in your geographic area, a Magellan representative will contact you about a week in advance to check your availability to provide the on-site service.
© 2007 Magellan Health Services This information is confidential and the proprietary information of Magellan.

Behavioral Health Provider Training for Post-Deployment Health Reassessment (PDHRA)
Overview of the U.S. Military
The United States Armed Forces and its Branches
Today’s U.S. military, or the United States Armed Forces, consists of five branches – Army, Air Force, Marine Corps, Navy, and Coast Guard. Each of these branches also has a Reserve component, which collectively, make up a significant part of the total military force. The Coast Guard is controlled by the United States Department of Homeland Security. The others are under the command of the Department of Defense. The President of the United States is the Commander in Chief of each branch of armed forces.
In addition to the branches above, each of the 50 states has a National Guard – Army National Guard and Air National Guard. These are commanded by the state’s governor; however, the President of the United States also has authority during national emergencies to assume control of any Guard component. The National Guard has made up a significant portion of the total military force involved in the recent Middle East wars.
The original descriptions/summaries for each military branch came, at least in part, from their own Web sites. They are reintroduced below in order to communicate what each branch wants to communicate to its readers, which is what should be communicated to our providers. The verbiage represents the attitude of service members that they start developing their first day in the military; this is important for each provider to understand as they present Battlemind, mingle with the members, and assess, educate, and try to get through to them in a time of need. This is not just verbiage; it is part of the service member mentality and the military culture.
“The U.S. Army is a key component of the U.S. Armed Forces and the strongest force in the world. It is made up of the best-trained, most dedicated, most respected Soldiers in the world — protecting America’s freedoms at home and abroad, securing the homeland, and defending democracy worldwide.”
The United States Air Force has the most sophisticated and technologically advanced aircraft in the world today. Combined with the best-trained pilots, ground crews, and other support personnel, the Air Force ensures air and space superiority and support for virtually every mission undertaken by the U.S. Military. It can attack anywhere, anytime and do so quickly and with precision.
The Marine Corps has two missions: to make Marines and win battles. As the smallest, most dynamic force in the U.S. Military today, the Marine Corps serves as the aggressive tip of the U.S. military spear. It is also the only forward-deployed force designed for expeditionary operations by air, land, or sea.
© 2007 Magellan Health Services This information is confidential and the proprietary information of Magellan.

Behavioral Health Provider Training for Post-Deployment Health Reassessment (PDHRA)
NAVY The United States Navy is the largest and most powerful naval force in the world and is equipped to handle operations both on and under the sea, in the air, and on the ground, anywhere around the world. Its mission is to have combat-ready Naval forces capable of winning wars, deterring aggression, and maintaining freedom of the seas.
COAST GUARD The primary role of the United States Coast Guard is to protect the safety of our nation’s coasts and waterways. Under this mandate, the Coast Guard performs a variety of missions, including maritime safety, mobility and security, national defense, and the protection of natural resources.
Members of the military, or service members, can serve in the military either on a full-time or part-time basis. If members are serving full time, they are considered to be on Active Duty; these members put on the uniform at least five days out of the week and work for their respective branches in one capacity or another, in peacetime or wartime. If part-time, these are the citizen-soldiers, -airmen, -marines, and –sailors that are a part of either the National Guard or the Reserve components. Most of these part-time members have fulltime civilian jobs, but they have volunteered to serve in the military also. They normally train for one weekend per month and two additional weeks per year; however, they can be activated to perform Active Duty service with short notice. During the recent conflict in the Middle East, these part-time members, especially those in the Army, have been activated and deployed multiple times to Iraq or Afghanistan for as long as 12 to 18 months, sometimes longer.
With more than 200,000 service members currently deployed worldwide, the Department of Defense and its military leadership continues to recognize, especially since the invasion of Iraq in 2003, that members who are deployed to war zones, such as Iraq or Afghanistan, often return home with deployment-related health concerns, family problems, and other psychosocial struggles that tend to surface about three to six months after returning from deployment.
The purpose of the PDHRA is to provide those returning service members an opportunity to identify deployment-related health problems and get assistance from government resources. In order to provide that assistance effectively, it is important to have some understanding of the military and its members.
© 2007 Magellan Health Services This information is confidential and the proprietary information of Magellan.

Behavioral Health Provider Training for Post-Deployment Health Reassessment (PDHRA)
The Day of the On-site PDHRA
Your Dress Code ƒ No tennis shoes, no open-toed shoes, no sandals, no beach shoes ƒ No jeans, no shorts, no skirts, no dresses ƒ No tank tops or halter tops ƒ No need to wear suit and tie ƒ Business casual-dress slacks and nice polo or dress shirt/blouse are appropriate ƒ May want to dress in layers, as the meeting place may be heated or cooled by large heaters or large fans, there may not be central heat or air conditioning.
Arrival Time ƒ Typically between 6:00 a.m. and 6:30 a.m., depending on travel arrangements and site location ƒ Meet your team at hotel lobby or on site ƒ Be flexible, as start time may be earlier or later depending on the site location, and how many service members must be seen. It is very important that every service member who is present go through the PDHRA process.
Set Up ƒ Assist the administrative team with room set-up, so as to maximize space and make flow of service members smooth and easy. Identify spaces for physician assistants (PA), nurses, behavioral health specialists, Vet Center and VA representatives, and administrative area; locate a sign-in table and table for tablets. ƒ Help unpack tablets and, if you are unfamiliar with the tablets, ask another team member to brief you on how to use them. If possible, you may want to ask a PA, so that he or she can also inform you where they would prefer you to document any relevant information from your assessment. ƒ Verify if site has DVD capabilities for the Battlemind Training presentation. If so, make sure the DVD copy is in cases; if not, be prepared to give oral presentation. ƒ Identify a room where you will be able to talk in private about confidential issues, where you will be able to complete a brief assessment with the soldier and identify any care issues or concerns. Ideally, the room would be located between the PA and the nurse; however, this is not always possible.
Formation ƒ The PA may do an introduction of the PDHRA process, team members, and purpose of the assessment. ƒ The PA may ask you, the behavioral health specialist, to say a few words about the role of behavioral health. At this point, start the Battlemind presentation on DVD or do the oral presentation. Depending on how the service members arrive, you may need to do the Battlemind presentation once, or several times. The presentation can last 30 to 45 minutes, depending
© 2007 Magellan Health Services This information is confidential and the proprietary information of Magellan.

Behavioral Health Provider Training for Post-Deployment Health Reassessment (PDHRA)
on the format used, and whether using the DVD or doing an oral presentation. If any questions or discussion topics come up, you may open up the floor, but it is not necessary to conduct a group discussion of the briefing. ƒ After the presentation, direct service members to the administrative area where they will begin the actual reassessment portion of the PDHRA process. Service members will complete the DD Form 2900. Be available to assist the service members as they fill out the questionnaires. You may hear service members saying that they have done something like this before; let them know that this is different in that they will meet with PA, nurse, and behavioral health specialist, if necessary. ƒ After service members complete the DD Form 2900, direct them to a PA. If the PA identifies that a service member has concerns related to mental health or behavioral issues, they may seek you out and ask you to do an assessment with the service member. (The nature of the behavioral health assessment and the accompanying documentation is covered in a later section of this training document.) ƒ At the end of the day, after all service members have been through the process, assist the administrative team with breaking everything down. Help put the room back in order – make sure tablets are re-packed, all documentation is complete and put away, all trash and shredded materials are removed from area, and wrap-up paperwork is completed. ƒ If asked to complete an after-action report, you can complete it there and send with other documentation in the black cases, or you may complete it after the event and e-mail it to LHI.
Flexibility ƒ It is necessary to be flexible with time, as all service members need to go through the process. ƒ It is necessary to be willing to help other team members, especially administrative members, as you may have more down time than they will.
Self-Care ƒ Bring snacks, water or other drinks. You may or may not get a lunch break, and it may be necessary for you to eat on the fly. ƒ If there is an opportunity for a scheduled lunch, it will be on your own and you will not receive reimbursement for it.
© 2007 Magellan Health Services This information is confidential and the proprietary information of Magellan.

Behavioral Health Provider Training for Post-Deployment Health Reassessment (PDHRA)
Battlemind Training Presentation
Purpose The purpose of the Battlemind presentation is to prepare service members for the behavioral health portion of the PDHRA. The presentation highlights mental health and substance abuse problems, in addition to addressing post-traumatic stress symptoms since deployment. The presentation sets the tone for the day, introduces the service members to resources, and can prompt service members to approach the behavioral health specialist to discuss presented issues. Generally, you are to give the Battlemind presentation right after formation, or prior to the completion of the DD Form 2900. The DVD is the military’s preferred presentation format; however, you need to be ready to present this training verbally, in case the site does not have DVD capabilities or you encounter technical problems with the DVD. If presenting verbally, you can give the service members the Battlemind Training brochure so they can follow along. You should be able to find copies of the brochure in the black equipment boxes or at the links below. Web Links You can visit the following Web sites to review the Battlemind presentation and outline as well as get copies of the Battlemind Training brochure:
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© 2007 Magellan Health Services This information is confidential and the proprietary information of Magellan.

Behavioral Health Provider Training for Post-Deployment Health Reassessment (PDHRA)
PDHRA Form (DD Form 2900)
The purpose of the PDHRA is to identify health concerns that have emerged since the most recent deployment and assist in more fully addressing the service member’s health care needs and concerns. The assessment is completed on the DD Form 2900. This form is a fourpage document typically accessed on a computer tablet, but it is also available in a hard copy format when necessary. The service member indicates his or her current demographics, assignments, medical health, mental health and substance use issues or concerns. A credentialed health care provider will review all health concerns identified on the DD Form 2900 with the service member.
© 2007 Magellan Health Services This information is confidential and the proprietary information of Magellan.
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