Embedded behavioral health providers: an assessment with the Army National Guard.
Although the Army has recently begun the practice of embedding behavioral health care providers (EBHP) in units in an effort to improve soldier well-being, the efficacy of this practice has not been evaluated. This study assesses 1 of the first programs implemented by the military. Using cross-sectional data obtained from a confidential survey of 12 company-level units in the California Army National Guard (n = 1,132), this study examines differences between units with and without EBHPs across a number of measures. Multilevel analysis of behavioral health symptoms, unit climate, perceptions of stigma, and practical barriers to care failed to detect main effects between units with EBHPs relative to those without. However, cross-level interactions were detected between unit EBHP status and soldiers reporting close relationship (e.g., spouse, girlfriend/boyfriend) impairment. Exploratory findings suggest that, among soldiers reporting close relationship impairment, those belonging to units with EBHPs reported significantly lower behavioral health symptoms and significantly more positive unit climates. Based on these limited exploratory finings, this study suggests that EBHPs in reserve units may have a positive effect on a subset of soldiers (i.e., those reporting close relationship impairment). More assessments of embed programs should be conducted, particularly using prospective longitudinal data among randomized units.
Department of Psychiatry, F. Edward Hebert School of Medicine, Uniformed Services University.
Dale W
DW
Russell
Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research.
Ronald J
RJ
Whalen
Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research.
Lyndon A
LA
Riviere
Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research.
Kristina
K
Clarke-Walper
Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research.
Paul D
PD
Bliese
California National Guard.
Darc D
DD
Keller
California National Guard.
Susan I
SI
Pangelian
U.S. Army Medical Research Unit-Europe.
Jeffrey L
JL
Thomas
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003625:Data Collection; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D011446:Prospective Studies; D057545:Social Stigma; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis*; D055815:Young Adult