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THE PHANTOM CORPS Welcomes Our Behavioral
Healthcare Network Providers January 9, 2007
AMERICAS ARMORED CORPS

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Fort Hood Statistical Snapshot

• 214,968 acres 335 square miles
• (5x the size of the District of Columbia)
• Maneuver area 136,094 acres
• Live fire impact area 63,000 acres
• 468 miles of paved roads
• 21 active access control points
• 447 miles of tank trails
• 5,043 active buildings
• 28,173,832 square feet (5x the size of the
  pentagon)
• 1,983 miles of utility lines
• 2 Airfields
• North Fort Hood mobilization site
• Current ongoing military construction 337M

(Data as of 8 Aug 06)
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THE FORT HOOD COMMUNITY AN ENDURING INSTALLATION

• 339K Total population served
• 56K Soldiers
• 220K Retirees/family members/ survivors
• 17K On-post family members
• 36K Off-post family members
• 4K Civilian employees
• 6K Service contractor employees
• 2K Volunteers each month

52 motor pools - 7.2 miles of combat power
9 on post schools 750 teachers 17K students
on/off post
TOTAL YEARLY ECONOMIC IMPACT 6.09 BILLION
(Data as of 8 AUG 06)
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Fort Hood 12 Month Deployment Cycle
SRP Soldier Readiness Processing Final Steps
getting Soldier ready to deploy. Pre-Deploymen
t Health Questionnaire Medical Threat Briefs,
Immunizations Mental Health Risks how to
access Family, FRG, Chaplain, Legal, Finance,
etc.
Mental Health Support During Deployment Brigade
Medics, Medical Officers, Chaplains Brigade
Mental Health Resources
Combat Stress Company Deploys Teams to augment
Brigades Units with increased requirements.
Combat Support Hospitals Mental Health Support
by Medical and nursing staff and embedded
Psychiatrist, Mental Health NCO
12 Month Cycle between deployment
is variable based on mission
requirements. Some Soldiers units are
redeploying in less than 12 months,
for the 2d, 3rd and even 4th time!
Rapid Evacuation to CONUS hospitals, as
needed.
Mental Health Treatment Self-Referrals,
Command- Referrals, etc.
Preparation to Redeploy Briefings by Unit
Leaders, Chaplains, Medical Officers
Post-Deployment Questionnaire
90 180 Day PDHRA
Post-Deployment Health Risk
Assessment Educate Soldiers about stress-related
symptoms Identify Soldiers with unmet
mental health and other needs (GOAL
Early Identification Early Treatment
Decreased chronicity return of a
functional Soldier) Educate Soldier how to access
mental health services. Link risks to
multi-disciplinary resources
Redeployed Home Station Reverse SRP
Provider Review Post-Deployment Questionnaire
Identify Soldiers needing immediate mental
health assistance. Educate Soldiers about
Stress-Related Symptoms Educate Soldiers how
to access mental health services.
Mental Health Treatment Self-Referrals,
Command- Referrals, etc.
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BLUF

• Fort Hood has been on a journey for the past two
  years to transform its mental health support for
  soldiers and their loved ones- for as much
  progress as we have made, we still have much
  further to go
• To that end, the four cornerstones of our efforts
  focus upon building resilience, managing risk,
  sustaining performance and resetting well being-
  mind, body and spirit
• Sustained by the Warrior ethos, we work together
  as a team to keep our arms around those in
  greatest need and to educate folks that seeking
  help is a sign of strength
• Failure is not an option.Were all in this
  together.. There simply is no greater privilege.

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Our Charge

• We put a lot of fine troops into harms way to
  make this country more secureWe have made a
  commitment to the troopsthat commitment is that
  we will provide excellent health care.
• President George W. Bush
• All Soldiers must be knowledgeable about
  available mental health services and feel
  comfortable using them.
• Honorable William Winkenwerder, Jr., ASD for
  Health Affairs

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Our Charge

• It is also critical that we acknowledge that
  this Global War on Terrorism places unprecedented
  burdens on our Soldiers and families.
• General Peter Schoomaker, Army Chief of Staff
• The human response to the stresses of combat
  operations is really almost a bell shaped curve.
  Some people are fine, some severely traumatized
  and in the middle is a large group who has been
  changed and may just need a little bit of
  counseling.
• LTG Kevin Kiley, Army Surgeon General

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Ft. Hood SoldierMental Health Requirements

• Cumulative deployment-related stress / trauma
  will likely increase need for sustained support
  continued emphasis on suicide prevention /
  relationship-building skills is critical
• Soldiers / Leaders must know how to access care,
  whether in garrison or deployed
• Need to overcome the actual and perceived stigma
  for Soldiers seeking and obtaining mental health
  services.
• Actual / perceived barriers
• Career Opportunities
• Security Clearances
• Relationship within unit among Soldiers
• Guilt failing to complete mission or letting
  unit down
• Outreach to Family Members is critical
• Family Readiness Group / Rear-Detachment Command
• Public Awareness Campaign
• Fort Hood Abuse Hotline - 287-2273
• Military One Source 800-342-9647
• Deployment Stress Careline 535-4497

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FORT HOOD Mental Health Programs Services

• Installation
• Well-Being Risk Reduction Program
• Fort Hood Town Hall Quarterly Meetings
• Inter-Agency Quarterly Council Meetings
• Family Readiness Group Assistants
• Military Child Education Coalition
• Schools (Liaisons with Community)
• Family Advocacy Specialists (Unit Reps)
• Housing Committee for On-Post Child-on-Child
  Abuse
• Wounded In Action Service Center
• Chaplain Family Life Training Center- Marriage
  and Family Therapy
• Outreach Soldier and Family Life Consultants
  (Pending)
• Army Community Service Family Advocacy Program
• Family Advocacy Committee
• Domestic Violence and Child Abuse Fatality Review
  Committee
• Installation Sexual Assault Review Board
• Sexual Assault Prevention and Response Program
• Victim Advocates
• Suicide Prevention Program

• MEDCEN (CRDAMC)
• Resilience and Restoration Center (Psychiatry,
  Psychology
• and Division BH assets 4th Infantry DIV and
  1st Cavalry DIV)
• Post Deployment Health Reassessment
• Care Managers in Primary Care Clinics
• Operation Gentle Landings
• Caring Hearts Bereavement Team
• Chaplains - Clinical Pastoral Education Program
• BH Care Liaisons (Case Managers-Social Service
  Assistants)
• Military Severely Injured Center (MSIC)
• Tri-Agency Council Social Work, Child
  Protective Services
• and Family Advocacy
• Partnerships/Relationships
• Veterans Administration (Waco, Temple Austin)
• TRICARE Partnerships
• Texas National Guard
• Texas Department of Human Services
• Behavioral Health Consortium Psychiatry,
  Psychology, Department of Social Work/ Family
  Advocacy Program, Department of Substance Abuse
  Services, Child and Adolescent Psychiatry and
  Evaluation Service
• Population Health

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Our Challenge Supporting the Global War on
Terrorism
Need for Deployable Soldiers
Treating Injured or ill Soldiers and Returning
them to Health
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Challenges

• Provide comprehensive mental health services
  supporting the Armys largest power projection
  platform in support of GWOT
• Significant mental health demand beginning 1-2
  months post deployment and continuing for several
  years (per our experience with supporting OIF 1
  2 redeployments)
• Complexity and severity of mental health needs is
  significantly greater
• Increased risks are reflected in a variety of
  destructive behaviors e.g.. domestic violence,
  sexual assault, suicide, motor vehicle accidents,
  and substance abuse

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Challenges

• Increasing frequency and/or length of deployment
  tours
• Increased and/or exacerbated emotional,
  psychological, financial and social problems
• Recruitment challenges in enticing desired mental
  health providers to relocate to Central Texas
  (Killeen)

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Challenges

• Increasingly being selected as area of country
  where retiring and separating service members are
  choosing to live
• Balancing needs and desires of line units in
  completing mission requirements with providing
  the best mental healthcare possible
• Pressure from line for return to duty to meet
  wartime demands
• Largest Army power projection platform

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Operation Gentle Landing Arrival
Wounded Soldier Reception / Operation Gentle
Landing (OGL)
One Team From Our Deployed Staff in Baghdad To
Our Reception Team
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Operation Gentle Landing Reception and Care
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Operation Gentle Landing Reintegration

• Care Management Program
• Family Assistance Center
• Reintegration with Installation
• Psychosocial Issues
• Transition of Soldiers Care to VA

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Medication Considerations

• A psychiatric condition controlled by medication
  should not automatically limit deployment
• Commanders should be made aware of deployment
  limiting medication use
• Medications shouldnt be started just prior to
  deployment should be stable for several months
  prior to deployment
• In general, anti-manic and anti-psychotic
  medications may limit deployability due to side
  effects
• In certain cases, low doses of anti-psychotics
  may be used for sleep and are compatible with
  deployment

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Questions?