The Public Health Service Officer in the Department of Defense CDR Dennis Slate, PsyD Brooke Army Medical Center LCDR M. Victoria Ingram, PsyD, ABPP Womack Army Medical Center LCDR Rick Schobitz, PhD Brooke Army Medical Center

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The Public Health Service Officer in the
Department of DefenseCDR Dennis Slate,
PsyDBrooke Army Medical CenterLCDR M. Victoria
Ingram, PsyD, ABPPWomack Army Medical
CenterLCDR Rick Schobitz, PhDBrooke Army
Medical Center

• The comments expressed in this presentation
  reflect the opinion of the authors and not the
  Department of Defense, the medical treatment
  facilities above, or the U.S. Army

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Objectives
1. Describe the clinical impact of officer
credibility in the military behavioral health
environment. 2.  Describe the PHS/Army
Psychology Internship and its role in recruiting
and training psychologist to assist with the DoD
mission. 3. Describe the efforts of PHS mental
health officers in response to the shootings at
Fort Hood. Essentially the FAQs regarding
culture, training, and impact.
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Press Release 2008
U.S. Public Health Service (PHS) Commissioned
Corps Officers to Augment Behavioral Health
Services in Military Treatment Facilities
(MTFs) The Assistant Secretary of Defense
(Health Affairs) and the Assistant Secretary for
Health, Department of Health and Human Services
(DHHS) sign a Memorandum of Agreement (MOA) to
allow for the detailing through TRICARE
Management Activity (TMA) of approximately 200
U.S. Public Health Service (PHS) behavioral
health officers to Military Treatment Facilities
(MTFs) within Continental United States (CONUS),
Alaska and Hawaii.
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Original Concept
- Officers to be detailed to MTFs will come
from both the ranks of the Commissioned Corps, as
well as direct civilian accessions. It is
anticipated that some of these civilian
accessions will be former DoD uniformed
providers. - Officers to be detailed in support
of the Psychological Health mission will include
psychiatrists, clinical psychologists, clinical
social workers, and psychiatric nurses. Where
possible, professionals who focus care in the
area of Traumatic Brain Injury, including
neurologists, nurses, speech pathologists, OTs
and PTs may also be assigned.
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Implementation

June 2008 First officer commissioned and
assigned to DoD site (Fort Bragg, NC) under this
initiative. May 2010 Approximately 110
officers assigned to DoD across multiple
sites. Officers from a variety of disciplines
with a broad range of prior exposure/experience
with the Department of Defense.
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CULTURE CREDIBILITY
Military Customs and Courtesy Wear and
Appearance of the Uniform Physical Fitness
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CULTURE CREDIBILITY

• The Enlisted Corps
• Differences
• Rank Title
• Fraternization
• The Officer
• Company Grade vs. Field Grade
• Level of Responsibility
• Leadership

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CULTURE CREDIBILITY
Deployment, Deployment Cycle and Support
Awareness
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CULTURE ETHICS ( Law)
Joint Ethics Regulation UCMJ Common Fallacies
regarding inconsistencies with the APA Ethical
Principles and Code of Conduct
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CULTURE ETHICS ( Law)
Military specific behavioral health
evaluations DoD 6490 Command Directed Mental
Health Eval Chapter MSE MSE for Drill Sergeant,
Recruiter, other duty Sanity Board SERE, SFAS,
MARSOC, etc Credentials AR 40-68 Waivers
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Requirements For All PHS Officers Detailed Thru
the DoD-PHS PH/TBI Initiative

• OBC required for all new accessions
• In processing Supplemental instructions
• Administrative orientation with DoD Commissioned
  Corps liaison officer
• Supplemental instructions on military courtesy
  protocol, uniform wear, physical fitness
• Orientation in providing PH TBI care in
  military populations

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Combined US Army/USPHS Psychology Postdoctoral
ResidencyBrooke Army Medical CenterFort Sam
Houston, TX
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End State

• Residents will be competent providers in the
  military health system and be prepared to provide
  services in garrison or when deployed
• Residents will be competent Officers, prepared to
  lead, serve as clinic managers, oversee enlisted
  staff, and serve as consultants to Commanders

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Rotations Training Sites

• SAMMC, Fort Sam Houston
• Warrior Clinic
• Community Behavioral Health Service
• Consultation Liaison
• Pain Clinic
• Army Substance Abuse Program
• External Rotation
• Fort Hood, TX

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Elements of Residency

• Direct Patient Care
• Management
• Didactics
• Weekly
• VTC availability for remote rotation
• Offer more specific military topics, in-depth
  knowledge about applying clinical skills to
  military population.
• Organized thematically for enhanced skill
  development
• Instruction from visiting experts in the field
  throughout year
• Center for Deployment Psychology

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Center for Deployment Psychology

• Mission Train mental health professionals to
  provide high quality deployment-related
  behavioral health services to military personnel
  and their families
• Conduct courses at the Uniformed Services
  University, Bethesda, MD
• Imbedded training personnel at MTFs, including
  Brooke Army Medical Center

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Fort Hood Response (PHS)

• Social workers on site (3), Psychologists sent
  TDY from BAMC (2) and DECO (2)
• Assigned to CRDAMC BH Operations Center and
  involved in direct clinical care
• Services focused on families of deceased,
  affected persons (civilian and military) at SRC

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Impact

• Served in BH leadership planning and delivery of
  clinical services to families of deceased and
  affected persons
• Completed Phase I of Fort Hood BH Operational
  Plan
• PHS officers assisted with and participated in
  Phase II planning and completion (16-26 Feb 2010)
  

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Questions?

• CDR Dennis Slate, PsyD
• Brooke Army Medical Center
• Dennis.slate_at_us.army.mil
• LCDR M. Victoria Ingram, PsyD, ABPP
• Womack Army Medical Center
• Mary.victoria.ingram_at_us.army.mil
• LCDR Rick Schobitz, PhD
• Brooke Army Medical Center
• Richard.Schobitz_at_us.army.mil