Child, Family, and School Behavioral Health Care in the Military Health System

Abstract

Army family member health and resilience directly impact soldier readiness and are critical to maintaining a deployable force. Military families face unique stressors, including combat deployments, that can negatively impact child and family functioning. In 2014, the Army implemented the Child and Family Behavioral Health System (CAFBHS), one of 11 standardized behavioral health (BH) programs supporting soldiers and their families. CAFBHS is a comprehensive model of care consisting of five interrelated components that function in a synchronous manner: 1) BH providers located in CAFBHS clinics within Military Treatment Facilities supporting and collaborating with Patient-Centered Medical Homes; 2) School BH that embeds BH providers in on-post schools; 3) Community Outreach which organizes military and civilian resources to support soldiers and families; 4) Standardized evidence-based/informed training curricula for BH providers and primary care managers (PCMs) in treating common pediatric BH disorders; and 5) Regional-level Tele-behavioral Health Consultation in support of PCMs. Patient report of therapeutic alliance is high and outcomes for depression, anxiety and posttraumatic stress disorder for adult family members exceed Army standards. This paper describes the implementation of CAFBHS and provides lessons learned to successfully sustain and expand this integrated BH model of care across the military health care system.