New mental health care initiative improves access to care and readiness Published May 8, 2023 By Shireen Bedi Air Force Surgeon General Public Affairs FALLS CHURCH, Va. -- Air Force mental health leaders implemented a new initiative to nearly all Air Force bases to improve access to mental health, increase access to support resources, and mitigate the impact on readiness. For more than a year, the Air Force Medical Service has been rolling out Mental Health Targeted Care, an initiative that helps Airmen and Guardians understand all of the available options for support and connects them to the right resource either in a mental health clinic or outside the military treatment facility with another supporting agency that best meets their need. A room plaque for the 341st Operational Medical Readiness Squadron mental health flight is pictured inside the base clinic June 23, 2021, at Malmstrom Air Force Base Mont. The mental health flight offers mental health services to active duty members and manages the Family Advocacy and Alcohol and Drug Abuse Prevention and Treatment programs. (U.S. Air Force photo by Heather Heiney) Photo Details / Download Hi-Res Through Mental Health Targeted Care, providers vector patients to the resources they need to resolve their specific concerns. If the mental health technician determines specialty care does not best suit the patient's needs, the staff vectors the patient to a helping agency such as Primary Care Behavioral Health, group therapy, Family Advocacy, a domestic abuse victim advocate, Military OneSource, a chaplain, a Military and Family Life counselors, the Alcohol and Drug Abuse Prevention and Treatment office, among others. This vectoring approach enables the medical staff to provide immediate attention for those whose concerns that must be addressed by a mental health provider, while connecting others whose needs are important but may not require clinical services and can be sent to a helping agency to receive timely care. According to Tritch, this approach has helped reduce wait times for immediate and follow up care. "For years, the Air Force has encouraged members to go to mental health when in distress, and that’s great. However, the increased demand left us unable to see patients as frequently as we needed,” said Maj. Amanda Kruszewski, the Mental Health Flight Commander with the 31st Health Care Operations Squadron, Aviano Air Base, Italy. “Meanwhile, we have multiplied additional mental health support resources such as Operational Support Teams, True North and primary care behavioral health. In addition, the mental health clinic opened up several evidence-based treatment groups that have benefited patients and opened access to individual appointments.” Mental Health Targeted Care also helps with Airmen and Guardian readiness. For those who require mental health specialty care, the reduction of initial wait times and time between appointments that is helped by Mental Health Targeted Care ensure patients receive care at the appropriate time and minimize time before they can return to duty. “There are members who seek care because they are experiencing some depressive and anxious symptoms, but do not necessarily meet the threshold for specialty mental health treatment,” said Capt. Aimee Dickson, Mental Health Officer In Charge with the 60th Operational Medical Readiness Squadron, Travis Air Force Base, California. “Due to [Mental Health Targeted Care], those who need to be seen by one of our providers in the clinic for mental health diagnoses will get consistent care. This allows us to better assess how treatment is working for them and make any necessary adjustments to best support them.” Tritch also explained that this connection to the range of supporting resources on base supports Chief Master Sergeant of the Air Force's Spectrum of Resilience, which emphasizes a holistic approach to seeking help, including building personal resiliency skills, connecting with friends and family, and reaching out to non-clinical support organizations. "There is a continuum of mental-health-focused resources on base," said Tritch. "Mental health providers work with those resources should members need to be connected to us. Essentially, we have a system of care that wraps around the individual no matter where they go, reducing time between when they need care and when they receive it." “As I see patients more frequently, patients are experiencing symptom resolution more quickly. All of the providers here care deeply about what they do and who they serve. There has been a palpable lift in tension as they are able to provide the best care. Watching them thrive as they see their patients improve has been a gift. This initiative has been a massive step in the right direction.” – Maj. Amanda Kruszewski, the Mental Health Flight Commander with the 31st Health Care Operations Squadron From the perspective of the Airman or Guardian, nothing changes through this initiative, only the process of deciding where and how they will receive the best support and care. It still starts with the individual walking into or calling their mental health clinic. From there, a mental health technician will go through what Tritch explained as a vectoring and triage process. “Our technicians will speak with the member, go through a number of questions and determine, in consultation with a mental health provider, if their concerns would be best addressed in the clinic or by other non-medical counseling services,” said Tritch. “If that Airman or Guardian is recommended to a non-clinical resource and is not comfortable with that choice, then they can still request to see a mental health provider.” The Mental Health Targeted Care’s pilot phase ended in the summer of 2022 following a year-long evaluation of the initiative at nine bases. Initial feedback from those pilot sites has been positive where they found that 51% of members who reached out had needs that were better met by other caring agencies and were connected to those resources, ensuring they received the support they needed more immediately. “We also found that we had more than 2,000 mental health appointments that became available for members who needed specialty mental health care,” said Tritch. “We have seen across the board that we were able to treat patients sooner, address the needs of the command more quickly, preserve readiness, and provide patients with more acute issues with the treatment they require and at the frequency they need.” Similar successes such as reduced intake wait times and times between appointments are already apparent as the initiative’s rollout continues. At Aviano, mental health providers witnessed an improved overall experience among the Airmen they support. “I have seen these changes revolutionize my own practice,” said Kruszewski. “As I see patients more frequently, patients are experiencing symptom resolution more quickly. All of the providers here care deeply about what they do and who they serve. There has been a palpable lift in tension as they are able to provide the best care. Watching them thrive as they see their patients improve has been a gift. This initiative has been a massive step in the right direction.” Currently, the Mental Health Targeted Care initiative has been rolled out in three phases across the Air Force. Additionally, the Defense Health Agency has adapted the Air Force’s Mental Health Targeted Care initiative and is developing its own pilot at 10 installations across the Army and Navy to help improve access to care for all service members.