By Rose L. Thayer

Killeen Daily Herald

Demand for outpatient behavioral health care has more than doubled at Fort Hood in the past five years, according to information from Carl R. Darnall Army Medical Center.

Data comparing fiscal year 2007 to 2011 show that across the board, demand has risen and Darnall is looking into a variety of programs and expansions to meet the need, said Lt. Col. Sharette Gray, chief of behavioral health for the hospital.

"We're continuing to expand," she said. "We are definitely expanding more because of the need and because of soldiers being back."

Between the many different programs, the department of behavioral health, which includes social work, is averaging 3,000 patient encounters a week, she said, with the department of social work seeing the biggest rise. In-patient beds show the slowest increase numbers, rising 46 percent.

This increase is reflective of the entire military. The Armed Forces Health Surveillance Center reported the number of visits for outpatient mental health treatment almost doubled, from just under 1 million in 2007 to about

1.89 million in 2011.

Gray said most of the soldiers at Fort Hood seeking help have been deployed between three to five times and have a wide range of behavioral issues for which they are seeking help.

Easier access

To meet the growing demand, Darnall is hiring providers, as well as integrating new care models across post, such as the Embedded Behavioral Health Model, which attaches providers to units at the brigade level.

"It gives them easy access," said Gray of the model that was launched at Fort Carson, Colo., in 2008. In October 2010, Fort Hood was the next installation to adopt it, and the team now resides within the footprint of 1st Cavalry Division's 4th Brigade Combat Team.

"We found that it helps with the stigma, that soldiers feel more comfortable coming there," said Gray. "It increases the continuity of care, because instead of coming to a place where they may see a different health provider each time, those providers are assigned to their unit. They are not part of the unit, but assigned to support it. They'll get to know those providers really well."

Lt. Col. Hope Rampy, commander of the 4th Brigade Special Troops Battalion, said the behavioral health team has been a unique and beneficial asset for the brigade's soldiers.

"It's helped knock down the stigma associated with mental health concerns," she said. "If a soldier is having issues, it's one of the top things I (suggest)."

Create continuity

One of the biggest benefits, Rampy said, is that it is always there, not just right after a deployment.

"It's something that's here long term, after the honeymoon phase," she said. "When a soldier says they need to go, they go. It's part of the culture now."

When questions or concerns arise about a soldier's care, the commanders know exactly who to call, creating continuity and fluidity. Rampy said they aren't reaching out to a stranger on the other side of post — it's someone who is familiar and invested in the unit.

Because of this success, Gray said Darnall plans to expand the embedded teams across Fort Hood.

Reset center

For soldiers needing more intensive behavioral health care, or treatment for post traumatic stress disorder, there is the Warrior Combat Reset Center.

Sgt. David Bryson, 96th Transportation Company, 180th Transportation Battalion, 4th Sustainment Brigade, 13th Sustainment Command, went through the three-week intensive outpatient program last June, and said he had a good experience. After five deployments in 11 years of service, he said he needed help to get out of the cycle of PTSD.

One of the treatments Bryson found especially beneficial was the neurofeedback treatment. For this, soldiers are connected to a computer by three electrodes on their head. The soldier watches an image, such as a flower blooming. They concentrate on the image and when they do, the image changes — the flower blooms more vibrantly.

As this happens, the brain begins to rewire itself, said Dr. Jerry Wesch, clinical psychologist and director of the reset center. He performs this treatment with soldiers in half-hour sessions, calling it a video game for the brain.

"As they get better, the mind works faster, memory works better, the control circuits for sleep work better," he said.

Wesch even bets the soldiers a dozen donuts on Monday that by Friday they'll be sleeping better. The office is full of donut boxes on Friday, he said.

Bryson's goal in attending the reset program was to be able to remain on active duty and reach 20 years of service for retirement. Even though he may be cut in the downsizing of the Army, Bryson said he is learning invaluable skills.

"My wife sees a difference. I have a longer fuse now," he said. "I'm not perfect, and I'm not cured, but its not the end. It's hope."

Other programs

Off post, programs such as Scott & White's Military Homefront Services also are seeing an increase in demand. This program launched in 2008 and provides free mental health care for service members and their families.

"The referrals started to increase as more and more soldiers had multiple deployments," said Leona Delano, the program's combat stress coordinator. "There has also been an increase because of the drawdown in both Iraq and Afghanistan."

Funding for Homefront Services comes from grants, so its ability to meet demand depends on the amount of funding they receive year to year. Delano said its licensed providers are able to refer soldiers back on post if they feel they need different or more immediate treatment.

Regardless of where soldiers want to go, Gray and Delano agree that there is help for soldiers who need it.

"We have help available," said Gray. "Our providers really provide world-class care and they really want to treat soldiers. They are motivated to helping soldiers, specifically. A lot of them volunteer to come here for that reason. Don't hesitate to get help. It's not a weakness, it's actually a sign of strength. It will set an example for others ... and it will make a difference."

Contact Rose L. Thayer at or (254) 501-7463. Follow her on Twitter at KDHmilitary.

How families are affected

The demand for marital and family therapy has risen right along side the demand of mental health treatment for soldiers.

Carl R. Darnall Army Medical Center has already begun expanding its Child and Adolescent Psychiatry Evaluation Service and family assistance center. The expansion will continue over the next few years, said Lt. Col. Sharette Gray, chief of behavioral health for Darnall.

Most families who utilize these services, she said, have endured multiple deployments alongside their soldier.

"The affect that (multiple deployments) have on the soldier definitely has an impact on the family," she said.

Scott & White's Military Homefront Services also sees family members and is experiencing the same trends, said Leona Delano, the program's combat stress coordinator.

"It's the coming and going of the service member. The family stays here and they go on. Sometimes children grow apart from their parent who is deployed," she said. "The spouses don't understand. They only know their loved one went away to war and came back different. They want the old person back. They can reclaim a lot, but they won't be able to go back in time."

Need treatment?

Soldiers interested in the programs available at Carl R. Darnall Army Medical Center should visit the Resilience and Restoration Center.

Walk-ins are welcome in building 36009 on Darnall Loop anytime during duty hours.

For more information, call (254) 553-2284.

For more information on Scott & White's Military Homefront Services, go to or call (254) 680-1139.

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