The Gateway

As the brigade psychologist for the 2nd Brigade Combat Team, 4th Infantry Division, using telebehavioral health (TBH) to conduct consultations has significantly increased my ability to provide services to a greater number of Soldiers in a more efficient and timely manner. Additionally, TBH has helped reduce some of the challenges that arise in connecting Soldiers with health providers downrange.

For commanders, determining when a Soldier may be in need of behavioral health services is not always readily ascertainable, particularly when a Soldier denies having problems or is not ready to ask for help. The thought of taking a Soldier out of the fight for several days would have considerable impact on the mission, not to mention the logistical challenge it would place on the platoon.

TBH provides for real-time video conferencing and grants an atmosphere similar to that of face-to-face interactions experienced in more traditional settings. As a result, the Soldier doesn't need to be moved or be held back from going on a mission to meet with an incoming provider, enabling units to maintain their combat strength.

In instances where the Soldier in need is not co-located with a TBH system, evaluations and follow-up services are easily coordinated around the unit's schedule; supporting both the unit and the Soldier.

While there have been a few minor growing pains in establishing the TBH systems, the benefits continue to be realized on a regular basis. I have found TBH greatly bridges the gap in accessibility and allows me to quickly assist commanders in constrained situations.

When I meet with a Soldier via TBH, at the outset of the interaction I make it a point to explain the nature of the TBH system, including the potential limitations in connectivity. I also make sure I obtain the Soldier’s consent to proceed with receiving behavioral health services via TBH during the first interaction.

Taking the time to do this helps the Soldier feel more comfortable and provides an opportunity to discuss any concerns they might have with using this system. This further engages the Soldier in the process and starts facilitating a therapeutic relationship.

The desert terrain coupled with the decentralized operations made it quite a challenge to move Soldiers or the health care providers to outlying locations, but TBH has proven to be a reliable and effective platform of increasing access to behavioral health providers despite these factors.

Capt. Cory Gerould, Brigade Psychologist, Regional Command – South, Afghanistan