Addressing Mental Health Needs in the U.S. Military: HNFS' Commitment to Comprehensive Care
Wednesday, July 24, 2024
by Dr. Joyce Grissom, Chief Medical Officer, Health Net Federal Services
At Health Net Federal Services (HNFS), we don’t just reflect on Mental Health Awareness during the month of May. We are constantly paying attention to the state of mental health within the armed services, and that reflection has led us to important insights. We’d like to share some of them here.
For background, the recent push by the military to destigmatize mental health has led to an increasing number of active duty service members (ADSM) seeking mental health support. It is a positive trend that comes with its challenges. Between 2005 and 2021, mental health diagnoses among military members quadrupled, resulting in a rapid and concerning increase in the need for mental health care providers. This came at a time when the nation was already facing a significant shortage of mental health care professionals, with nearly half of the country living in mental health workforce shortage areas.
As the manager of TRICARE’s civilian provider network in the West Region, HNFS’ first step to address this increase was to grow our collaborations with the Department of Defense (DOD), community providers, and military support organizations (MSO). The strength of these collaborations became critical to achieving and maintaining timely and specialized mental health care—within 28 days of referral for standard cases and within 72 hours for urgent needs. Collaborative partnerships such as these gave rise to our most useful solutions, including improvements to notifications directing the time and order that care is delivered, and the expansion of telemedicine to overcome the physical boundaries of care.
Today, these solutions are especially impactful in military installations designated as "remote or isolated." Nearly 80% of these remote installations are in the western U.S. and fall under HNFS' management. Service members in these remote areas are at higher risk of experiencing depression and suicidal ideation, making it that much more important to ensure mental health support is both timely and accessible.
For example, when the number of suicides among ADSMs reached a record high in 2020 in the medically underserved state of Alaska, HNFS initiated a project to maximize the number of mental health care providers available and reduce time to receive specialized care. As part of the project, HNFS recruited additional telemental health and regional providers that would commit to initiating rapid care for ADSMs at risk of suicide. To assist in the effort, HNFS’ care management team worked to provide additional oversight to ensure that time to care commitments were met. In addition, the care management team developed tools and training that were shared with the regional military hospital to ensure that high-risk service members remained engaged in treatment over a span of twelve weeks.
HNFS has taken additional steps in partnership with the DOD to analyze individual medical records and suicide event reports to better understand how health, social, and cultural factors interact with life events. Since then, we have seen improvements to how we identify ADSMs who are at risk of suicide and can better provide preventative services and case management.
The progress we’ve made is making a difference – one service member at a time – but it is not possible without the additional support of an outstanding network of national MSOs that help military families navigate TRICARE and VA benefits. Together, we are advocating for further advancements, including coverage of certain FDA-approved digital therapeutics and a system-wide implementation of artificial intelligence prediction algorithms to better understand an individual’s risk of suicide.
While much work remains, HNFS is dedicated to fostering the level of collaboration needed for a better future for military mental health. Our ongoing efforts are aimed at ensuring every ADSM has access to the high-quality mental health care they deserve, thereby building resilience and well-being within the U.S. military.
