JOINT BASE ANDREWS, Md. - The area of behavioral health in the National Guard has changed significantly in the years since 9/11, according to the Army Guard's top behavioral health officer, and continues to change to meet the needs of the force.
"I think there is more attention in general to behavioral health for Soldiers and their families," said Army Lt. Col. Laura Wheeler, chief behavioral health officer for the Army National Guard. "I know that from the top level of our chain of command, down to the foxhole, leaders are engaged in making behavioral health and resiliency a priority for our National Guard members and their families."
The same is true for the Air National Guard as well.
"The mental health landscape has changed ... and like the Army Guard, a substantial amount of Air Guard members who have deployed have come back with some kind of diagnosable mental health condition, namely traumatic brain injuries or Post Traumatic Stress Disorder," said Air Force Lt. Col. Darrick Cunningham, behavioral health branch chief for the Air National Guard, "and as a result there has been a growing need for mental health services."
Wheeler, who came to the National Guard Bureau in 2009, said that at the time, "there was no full-time behavioral health officer. Returning Guard members coming back from a deployment face significant challenges when reintegrating with their family, communities, work and school."
Another challenge Guard members face is access to resources.
"Aside from drill weekends, they are separated from their units when they return, often living across large geo-dispersed areas, and this is unlike their active duty counterparts who kind of decompress together," Wheeler said.
Cunningham agreed.
"The Guard is very geographically dispersed, so if you are only building these capacities around the wing or the armory, then you've missed the mark."
To prevent this issue, Wheeler said the National Guard began hiring directors of psychological health, or DPH.
"In 2009, we leveraged the [Army Guard's] psychological health program based on the 2007 Mental Health Report ... and since then we've been able to hire one director of psychological health per state, and in the last two years we have hired an additional 24 DPHs to cover the ‘at risk' states," said Wheeler, describing states that have a higher-than-average number of deployed Soldiers, or showed issues relating to financial, marital, or legal amongst the ranks.
Army National Guard DPHs typically work at the state level, a difference when compared to DPHs who work with the Air National Guard, according to Cunningham.
"Our DPHs are embedded within each wing, and in states where we have what we call geographically separated units, we've assigned additional DPHs," Cunningham said. "All of our DPHs are out in the local communities every day building capacity and creating a local network of services ... that are military sensitive and more aware of the nuances involved in treating and taking care of our Service members ... so our Soldiers and Airmen are getting the best care."
As a part of the team, Cunningham said DPHs invest a lot of time and energy into training commanders and teaching them to be the role model when it comes to seeking mental health issues.
"It's a way to help reduce the stigma," he said.
Wheeler said any stigma has been reduced since 9/11.
"Our goal in behavioral health is to get you on orders to get you the care that you need," she said. "It's okay to check on our emotions and feelings, and we need to continue to normalize that. You wouldn't whisper about getting your eyes checked, so why do that when you talk about behavioral health?"
Currently, Soldiers and Airmen can access their local DPH for information on resources in their area to help with a wide variety of behavioral health issues.
"Right now, there are a lot of programs out there that [Guard members] and their families do not know about," Wheeler said. "The DPHs have established state directories of the resources that each state has to offer, and though resources could be unique to each state, every state has something to offer."
Guard members can use an app to locate DPHs.
"We also have an app called Ready54," Cunningham said, "that you can pull up and it will find your location and tell you within a certain number of miles that there is a DPH, whether it's Army, Air Force Reserve, active duty - whatever - and you can call that person up and schedule some intervention from that person.
"It's important to mention that, because Guard members are so geo-dispersed and we want to solve that problem of access to resources."
Both agree that a face-to-face appointment with a DPH is typically the best approach when seeking help, because the DPH may ask Guard members a question that triggers a previously unidentified need.
Other resources Guard members can leverage also include the Vets4Warriors 24/7 call-in center, which is a peer-to-peer support center, Wheeler said.
She added that National Guard family program directors and Family Assistance Centers are also huge resources, especially in the geo-dispersed areas where they can cover down on Service members, families, retirees, and veterans.
For Guard members who want to seek out resources on their own, Wheeler said the Guard Your Health website is the best place to find information posted by the behavioral health program.
Wheeler said the future of behavioral health looks promising for current and future Guard members as she highlighted the push to bring aboard uniformed behavioral health officers.
"They will be able to cover down on a lot of what military medicine can provide that the civilian contractors cannot, such as temporary profiles and orders to get the care that Soldiers need," she said.
"I am also pushing for tele-behavioral health capabilities for the National Guard," she said, "so Service members can access resources and their DPH through video."
Wheeler said she sees the National Guard behavioral health programs as an enduring requirement for medical readiness and that personnel need to be in-place to assist Soldiers and Airmen whenever that individual seeks out behavioral health resources.
"Don't be afraid to see your leadership about behavioral health issues you might be having; make it a priority," she said.
"I also think families are important," she said, "and they want to help their Soldiers - they need to be involved - and I think parents also need to be involved."