Article

Postdeployment Health Reassessment: a sustainable method for brigade combat teams.

Division Surgeon, Third Infantry Division, Building 620, Fort Stewart, GA 31314, USA.
Military medicine (Impact Factor: 0.77). 11/2007; 172(10):1017-23.
Source: PubMed

ABSTRACT The Postdeployment Health Reassessment (PDHRA) was mandated in 2006 and the 3rd Infantry Division was the first unit to perform a large-scale implementation. This article outlines a reproducible model for conducting PDHRA using only existing resources.
The PDHRA (DD 2900) screening and referral processes are reviewed and data on positive screens are reported.
Of the 12,817 soldiers who participated in the mass screening, 1,460 (11.4%) were referred for behavioral health, 815 (6.4%) for primary care, 71 (0.01%) for specialty services, and 9 (0.001%) for emergency services. Consult requests were higher in maneuver brigades than in support units (12.1% versus 8.6% for behavioral health and 6.9% versus 4.4% for primary care referrals). All (1,460, 100%) of the behavioral health consults were completed on-site and the unit incurred no additional financial cost in conducting this process.
This method for performing a large-scale implementation of the PDHRA provides a flexible, efficient, and cost-effective process that could be implemented at the brigade combat team level without difficulty and in most locations without significant impact on other medical demands.

0 Bookmarks
 · 
107 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: US soldiers are required to undergo screening for depression, posttraumatic stress disorder (PTSD), and other mental health problems on return from service in Iraq or Afghanistan as part of routine postdeployment health assessments. To assess the influence of the anonymity of screening processes on willingness of soldiers to report mental health problems after combat deployment. Anonymous and nonanonymous surveys. US military. US infantry soldiers' reporting of mental health problems on the routine Post-Deployment Health Assessment was compared with their reporting on an anonymous survey administered simultaneously. The Primary Care PTSD Screen, the Patient Health Questionnaire-2 (modified), the suicidal ideation question from the Patient Health Questionnaire-9, and several other questions related to mental health were used on both surveys. Soldiers were also asked on the anonymous survey about perceptions of stigma and willingness to report honestly. Of 3502 US Army soldiers from one infantry brigade combat team undergoing the routine Post-Deployment Health Assessment in 2008, a total of 2500 were invited to complete the anonymous survey, and 1712 of these participated (response rate, 68.5%). Reporting of depression, PTSD, suicidal ideation, and interest in receiving care were 2-fold to 4-fold higher on the anonymous survey compared with the routine Post-Deployment Health Assessment. Overall, 20.3% of soldiers who screened positive for depression or PTSD reported that they were uncomfortable reporting their answers honestly on the routine postdeployment screening. Current postdeployment mental health screening tools are dependent on soldiers honestly reporting their symptoms. This study indicates that the Post-Deployment Health Assessment screening process misses most soldiers with significant mental health problems. Further efforts are required to reduce the stigma of reporting and improve willingness to receive care for mental health problems.
    Archives of general psychiatry 10/2011; 68(10):1065-71. DOI:10.1001/archgenpsychiatry.2011.112 · 12.26 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Vanderbilt's study used de-identified Service member (SM) PDHA and PDHRA responses and Military Health System contacts; anonymous SM surveys; analysis of de-identified assessment recordings; and assessment site observations and interviews with key unit and program administrators. Key findings included the PDHRA was associated with increased medical contacts regardless of referral status; SM responses on the assessment were the primary factor in clinician queries and referral decisions; clinician documentation and referral decisions were less consistent than SM responses; assessments conducted telephonically led to similar findings as those conducted face-to-face regarding clinician concerns, but resulted in fewer referrals; factors in the context of the assessment were associated with SM openness; clinicians could benefit from PDHRA-specific training; educational resources were valued by the SM but not commonly provided; and the additional questions about alcohol use did not provide added value. Recommendations were provided.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Psychosocial screening tools are routinely used by adolescent medicine providers to evaluate risk-taking behaviors and resiliency. A large number of U.S. military service members are adolescents, and many engage in behaviors that cause morbidity and death, such as tobacco use and binge drinking. Health care providers should consider the regular use of a psychosocial screening method to evaluate risk-taking behavior. The Home, Education, Activity, Drugs, Sex, Suicide, and Safety method is used to evaluate the home environment, educational and employment situations, activities, drug use, sexual activity, suicide, and safety during health care visits. This technique, originally created for a civilian adolescent population, can be used with minimal adjustments to evaluate behaviors of military service members.
    Military medicine 01/2009; 173(12):1164-7. DOI:10.7205/MILMED.173.12.1164 · 0.77 Impact Factor

Preview

Download
2 Downloads
Available from