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News | May 24, 2022

Mental Health is a Team Effort

By Claudia Sanchez Bustamante

The Military Health System offers a wide variety of mental health care options. But figuring out who is the best person to talk to can seem overwhelming. There are psychiatrists and psychologists, counselors and therapists.

Each one specializes in different areas based on their training and patients' needs, which can include talking and providing temporary support through trying times or it may involve testing, assessing, diagnosing, and treating more serious mental health disorders.

Across the health care system, these professionals often work together to help beneficiaries find the right provider or combination of providers. You can find more information at Health.mil, from TRICARE, and individual military hospitals and clinics can also help guide you. Here's a rundown of some providers' specialties and basic information about each:

Psychiatrist: A psychiatrist has a medical degree and is trained to diagnose and treat mental disorders, says Kate McGraw, a clinical psychologist and chief of the Defense Health Agency's Psychological Health Center of Excellence. "Many have additional training to provide psychotherapy," she said.

But "because they're physicians, it takes longer to train them and they're harder to find," says Air Force Col. Scott Sonnek, a clinical psychologist and the Air Force's director of psychological health.

"[Psychiatrists] are more prepared for prescribing and assessing medical and more serious mental health conditions, such as schizophrenia or bipolar disorder which need significant medical management."

Psychologist: "A psychologist has a doctor of philosophy or doctor of psychology degree. They are licensed to conduct psychological testing and assessment, diagnose, and treat mental disorders, usually with non-pharmacological methods through psychotherapy, although some psychologists are also licensed to prescribe medication," said McGraw.

Sonnek said "psychologists are better trained for talk therapy and research and psychological testing."

Through testing, they can gather specific information about an individual's functioning, to include symptoms, personality, and intelligence.

While both provide "treatment to similar populations for the same set of mental health disorders," McGraw said, "psychiatrists can often provide medication when symptoms are severe or impairing daily function, or if someone doesn't respond to psychotherapy interventions."

"There are multiple pathways to care with either a psychiatrist or psychologist," she said. "Often, a primary care provider will make a referral to specialty mental health care or to an integrated behavioral health provider who is part of the primary care team if needed. In other cases, the beneficiary can make their own appointment without a referral."

Sonnek suggested starting with the most accessible provider available to evaluate the problem. "Most people don't have significant mental health problems requiring a medication," Sonnek said. "So, talking it through with a professional is a great idea."

In fact, mental health care often begins with a psychologist or social worker, McGraw said. If medication is indicated, a psychologist or other provider can refer the patient to a psychiatrist for medication management."

Other Professional Support

Beyond psychiatry and psychology, there are several types of trained professionals within the MHS to support mental health. McGraw defined them as follows:

Licensed Clinical Social Workers have at least a master's degree and are trained to diagnose and treat mental disorders through psychotherapy, focusing on social systems surrounding the individual.

Licensed Marriage and Family Therapists have at least a master's degree in counseling, and training to assess and provide support for families and married couples.

Certified Psychiatric Nurse Specialists or Psychiatric Mental Health Nurse Practitioners are registered nurses with a specialized master's degree to help manage prescriptions and provide counseling for a range of mental health problems.

TRICARE Certified Mental Health Counselors have a master's degree in counseling and are trained to provide counseling, rather than psychotherapy. (Typically, counseling involves brief treatment targeting a specific symptom or concern, while psychotherapy often involves longer-term treatment and aims to address broader mental health concerns or treat mental health disorders.)

Supervised Mental Health Counselors are trained mental health professionals with a master's degree in counseling. They can provide counseling, rather than psychotherapy, under the supervision of another licensed provider, for example, certified drug and alcohol abuse counselors.

Pastoral Counselors can also provide spiritual guidance to individuals, couples, families, and groups in various settings.

Chaplains are also available to provide pastoral counseling. However, they do not provide treatment for mental health disorders, McGraw said. Military chaplains are typically part of military commands, although many are not directly involved with the MHS. Nevertheless, chaplains can refer someone back to a military hospital or clinic for medical treatment if they feel that's appropriate.

Linking the work of chaplains with the MHS's broader mental health care system has been a priority for military leaders, McGraw said.

"The Department of Defense has been actively strengthening the collaboration between chaplains and mental health providers over the last decade through a dedicated work group and webinars, as well as developing training curriculum to enhance the connection," she said. "There continue to be ongoing opportunities for mental health providers and chaplains to collaborate and share knowledge."

Additional Resources

Counseling is also available through Military OneSource and through Military and Family Life Counselors. However, these services do not provide medical treatment for mental disorders, says McGraw.

"They provide time-limited counseling for specific short-term problems such as stress, relationship conflicts, or phase of life disturbances," she said. These counselors can also help any beneficiary to locate the right provider if more medically oriented treatment is required.

The VA Vet Centers provide counseling for short term problems for active duty service members in certain circumstances. That might include care for the psychological impact of sexual trauma and readjustment counseling for combat veterans, even if the individual is still on active duty. They don't provide medical treatment for mental health disorders.

The military's Family Advocacy Program offers prevention and interventions for maltreatment of children and intimate partner violence, often through Licensed Social Workers.

The Psychological Health Resource Center is a call center with dedicated staff to help connect all beneficiaries to care.

For active duty service members or veterans, the in Transition program assigns a master's level coach to each person seeking care, regardless of separation status or date, to find the best behavioral health care option.

Finally, your primary care team often has a behavioral health consultant assigned to the team, and can help connect a beneficiary to behavioral health care, concluded McGraw.

Would you like the latest TRICARE news sent to you by email? Visit TRICARE Subscriptions, and create your personalized profile to get benefit updates, news, and more.
 

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