Mental Healthcare Program Meets Unique Needs of Military

August 27, 2018

Combat stress, PTSD, depression, anxiety, and substance use disorder are genuine, serious and treatable medical conditions. Here’s how one operator is tackling all of them.

Military service members and veterans continue to pose unique healthcare needs and increasingly prevalent behavioral health challenges.

U.S. Department of Veterans Affairs data reveals that as many as one in five veterans who have served in Iraq or Afghanistan may experience symptoms of PTSD in a given year. Every day in America, some 22 veterans commit suicide, just short of one per hour. And while veterans make up only 8.5% of the overall population, they account for 18% of all suicide deaths. In recent years, more active duty soldiers have died from suicide than combat operations.

Universal Health Services (UHS), through its extensive mental health treatment network of over 300 behavioral health centers in the U.S., U.K., and Puerto Rico, offers mental health treatment for the general public, as well as treatment programs specific to U.S. active military and veterans.

Over the past 15 years, UHS has significantly expanded its collaborations with military leaders and behavioral health experts including the establishment of the UHS Patriot Support Program (PSP) in 2001. PSP was born to support and compliment the care provided through the Department of Defense and Veterans Administration and to ensure consistency in practices across Patriot Support facilities.

The role of the PSP is to provide a consistent set of core standards and practices across participating PSP treatment facilities. While there is a core standard of care, each program constantly evolves to meet the often-unique needs of the military or veteran community it serves, utilizing the latest evidence-based treatment modalities. UHS works closely with local installation command to carefully customize its programs.

All UHS Patriot Support Center facilities are TRICARE certified and contracted with TRICARE-designated managed care organizations. The facilities also accept Medicare, Medicaid, and most private insurance plans.

As a former military officer and founder of the largest provider of inpatient behavioral healthcare in the nation, Alan B. Miller, CEO and chairman of UHS, has a special affinity for this group of patriots.

“After graduation, I was commissioned in the U.S. Army and served in the 77th Infantry Division,” says Miller. “UHS’ commitment to military members and their families, for me, is very personal. Like all of our behavioral healthcare treatment, our PSP demonstrates our commitment to total patient care-treating the mind and body of our patients and enabling them to live their best life.”

Military-specific approach

Today, 11 UHS behavioral health PSP “Centers of Excellence” and 13 Support Service Centers coordinate closely with medical and clinical staff at military installations to provide dedicated, specialized treatment programs for service members, veterans and their dependents. In 2017, PSP facilities served some 6,500 service members and veterans utilizing evidence-based treatment models. The vast majority of PSP treatment centers are located in close proximity to installations, providing convenient, secure, 24-7 access for patients, their families and base commanders.

During the past decade, increased investment in research and education often headed by dedicated military and VA clinicians has resulted in promising advances in diagnosis and treatment, according to Miller. “Similarly, there is improved public recognition that combat stress, PTSD, depression, anxiety, and substance use disorder are genuine, serious and treatable medical conditions,” he says.

Miller encourages healthcare executives and other stakeholders to help end the damaging stigma concerning mental illness.

“A key facet of this comes in the form of highlighting the issues of PTSD and post-combat transition as part of the overall national dialogue on mental illness,” he says.

PSP treatment centers operate as distinct, specialized and independent units within the larger hospital setting and the treatment programs and protocols are tailored toward the unique requirements of military life, culture and chain of command.

This often includes:

  • A dedicated military program director at all facilities to coordinate closely with command with expedited 24/7 facility access and progress updates;
  • Hiring staff with significant VA and/or military patient care experience;
  • “Total Force Fitness” modalities integrating robust physical, mental, social, and spiritual strength;
  • Mandatory training of clinical staff in military cultural sensitivity and practices;
  • Custom military themed facility designs and fixtures (e.g., flagpoles and branch flags);
  • Integrating graduation and/or military style “coin” ceremonies at the conclusion of treatment.

“There is no one-size-fits-all treatment approach for PTSD and post-combat transition,” Miller says. “Each patient is therefore provided individualized treatments to aid in their recovery and goal of living a fruitful life, whether on active duty, a civilian or family member.”

Aligning care with value-based initiatives

“The rapid transition from a primarily fee for service to value-based model has been underway for many years,” says Miller. “While successful implementation of outcome benchmarking in the behavioral health space has been slow or in some cases non-existent, UHS’ facilities including PSP centers represent notably positive exceptions.

“Our approach to value is centered on a key question which is often overlooked: ‘Did the patient get better?’ To help ensure that the answer is ‘yes,’ for the past several years PSP facilities have dramatically increased investment in and utilization of a wide variety of evidence-based clinical outcome assessment, patient satisfaction, and clinical benchmarking tools linked to improved treatments, outcomes, and overall value,” he says.

For example, the Post Traumatic Stress Disorder Checklist, is a widely used measure of PTSD symptoms including those focused on specific experiences from military service and other non-service related trauma.

“We are pleased to report that the results of these and similar evidence-based assessment tools demonstrate that approximately 80% of patients receiving care at PSP facilities for PTSD symptoms experienced clinically meaningful improvement,” Miller says. “UHS and PSP facilities continue to expand and refine the use of outcome measurement to benchmark our performance and to ensure that our programs continue to provide superior level care.”

PSP programs range from well-established, evidence-based therapies leading to quality patient outcomes to groundbreaking research incorporating innovative treatments that can aid in a faster and more lasting recovery for veterans living with PTSD and other conditions. Some of the specialty programs and treatment modalities include:

• Emerald Coast Behavioral Hospital (Panama City, Florida): Yoga instituted as a treatment in 2015; benefits for reducing stress in the body and mind.
• Laurel Ridge Treatment Center (San Antonio, Texas): Transcranial magnetic stimulation focuses electronic pulses on small areas of the brain believed to control mood and the source of symptoms for PTSD.
• Chris Kyle Patriots Hospital (Anchorage, Alaska): Six-week creative arts therapy program with a focus on progressive music therapy as well as other art forms; recently highlighted at a White House event.
• The Vines Hospital (Ocala, Florida): Equine therapy supports veterans suffering from challenges including PTSD and substance abuse.

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