Cannon AFB Medical Group continues targeted care model

Story by 2nd Lt. Merit Davey

27th Special Operations Wing

The 27th Special Operations Medical Group began implementing the Department of the Air Force’s Targeted Care mental health treatment model, here, in 2021, and has continued the process as it was approved across the Defense Health Agency in 2023.

Have you ever been to the emergency room for a broken bone? You were likely referred to the radiology department for an x-ray, and then possibly to an orthopedic doctor for follow-on care.

When a patient presents physical symptoms to a medical clinic, they are triaged and treated by the appropriate specialists. Targeted Care allows the 27th SOMDG to treat mental health symptoms the same way.

Targeted Care aims to match individuals seeking mental health care to the appropriate support, with the goal of increasing mental health care access for Airmen and their families across the base.

Targeted Care protocols help Airmen receive the right care at the right time, increasing unit readiness and reducing the wait time for mental health services. The program will allow 27th SOMDG providers to more efficiently use existing mental health resources to meet current demands.

“This model will ensure our Airmen and their family members are being treated by the best person in the right position to help them reach success and a better state of mental health,” said U.S. Air Force Col. Danielle Cermak, 27th SOMDG commander. “It will also ensure we are using our mental health resources, whether that be the behavioral health clinic or the Preservation of the Force and Family (POTFF) teams, appropriately.”

* What is Vectoring?

Under Targeted Care, mental health providers “vector” help-seeking individuals, conducting a preliminary assessment to match patient needs with the correct resources across the continuum of care. Sometimes the best resources are clinical options like behavioral health, and other times it may be non-clinical resource like the 27th Special Operations Wing embedded Military and Family Life Counselors (MFLCs), Integrated Resilience Optimization Network (IRON) teams and POTFF teams. Other non-clinical resources available to Airmen at Cannon AFB include the Military & Family Readiness Center and Military OneSource.

According to a 2023 Air Force Medical Service data analysis, 80% of service members who presented to DAF mental health clinics over the last decade did not have a mental health disorder, meaning the issues bringing them to the clinic did not meet the level of distress or dysfunction requiring clinical care, as defined by the American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition” (DSM-5).

Vectoring prevents individuals experiencing everyday life struggles from being unnecessarily diagnosed and treated for a mental health disorder, reducing unnecessary profiles, increasing efficacy of care and protecting mission readiness. Vectoring also ensures clinics retain the capacity to support service members presenting symptoms that require a higher level of mental health care.

* What does the Targeted Care process look like at Cannon AFB?

There are five basic ways that a service member might arrive at a mental health clinic: independently walking in or calling; a referral from another physician; a self-initiated or supervisor-facilitated referral via the Brandon Act; as required for a clearance or special duty; or a Command Directed Evaluation.

When Air Commandos who are not yet patients make initial contact with the behavioral health clinic, regardless of their method of arrival, they are assessed by a mental health technician for vectoring. If the member has symptoms that do not represent a mental health disorder, they will be vectored to the appropriate non-clinical resource.

During this assessment at the behavioral health clinic, which can be the same day or up to a few weeks later, depending on symptom severity and the clinic’s schedule, a thorough evaluation will be completed. After an approximately one-hour medical record review and interview assessment, the mental health clinician will discuss diagnosis (if applicable), treatment goals, modality of treatment (e.g. group therapy, individual therapy, virtual therapy, couple’s or family therapy, talk therapy, medications, etc.) and length of treatment with the patient. These conclusions are what lead to the appropriate vector.

For example, a member expressing anxiety associated with a missed paycheck may be vectored to the MFRC, as it could provide avenues for financial assistance, including helping the Airmen resolve the missed paycheck and providing skills to work through the anxiety caused by the situation.

However, all individuals seeking care have the option to request a clinical behavioral health appointment, even if the initial screening recommends a different route of care, or a non-clinical service.

“There are so many resources on the base for anyone who is seeking to help navigate challenges we are often faced with in life,” said Amy Egbert, 27th SOW IRON deputy program manager. “Between our True North program that provides embedded counseling services and our Preservation of the Force and Family programs, there are people to talk to embedded in each unit available to help navigate life’s challenges.”

* Will I be placed on a profile if I go to the behavioral health clinic?

The short answer is – it depends. Profiles help clinicians communicate potential risks to commanders and enables members to continue receiving care uninterrupted by deployments or PCS activities. When profiles are entered appropriately in a timely manner, it makes it easier to restore an Airman’s worldwide duty status.

Mobility profiles may be provided to patients with mental health symptoms that can impact their ability to do their job, allowing them to focus on their treatment while preserving mission capabilities. These profiles can include many duties, like arming, use of force, flight status, Personnel Reliability Program, and Top-Secret security clearance.

The 27th SOMDG behavioral health clinic’s priority is helping patients achieve remission as quickly as possible so they can fully return to health and work.

If your situation warrants a profile, you may be placed on one – but each situation is different and this is a topic you should discuss with your provider.

* What kind of clinical mental health treatments can I expect from the
Cannon AFB behavioral health clinic?

Clinical mental health treatment has a strong focus on achieving remission, which means treating a patient to the point where their symptoms no longer meet the criteria for having a mental health disorder. Treatment goals will typically include improving functionality at home and work, fitness and suitability for service, and rehabilitating duty-impairing symptoms.

For most patients, evidence-based treatment groups are the most effective stand-alone treatment to address most symptoms and conditions. The 27th SOMDG behavioral health clinic offers a variety of group therapy opportunities, including cognitive behavioral therapy for anxiety, depression, and insomnia, dialectical behavior therapy, enhanced clinical care, intensive outpatient treatment and more.

Individual treatment is typically reserved for patients who, due to their mental health symptoms, are not ready for a group setting. This determination occurs between each individual patient and their clinician.

Both individual and group settings pursue the same goal: helping patients process their fears, frustrations and expectations regarding their mental health and treatment. Treatment is a collaborative effort of both patient and clinician, and patients are always empowered to ask questions if something does not make sense.

* What kind of mental health support can I expect from Cannon AFB’s embedded programs, like POTFF and MFLCs?

Typically, POTFF and MFLC resources proceed with talk therapy. These resources can provide members with life skills like stress management, adjusting to military life, deployment-related challenges, relationship difficulties and more.

* What mental health support is available at Cannon AFB for dependents?

Dependents can be seen by any embedded 27th SOW MFLC of their choice, regardless of unit. The wing also has MFLCs embedded in local schools.

Additionally, Cannon AFB was recently awarded an exceptional family member program contract to provide more clinical resources to dependent children and spouses. The contract’s resources, a part of the DAF Surgeon General’s Developmental and Behavioral Family Readiness Clinic, is projected to reduce Cannon AFB EFMP denial rates from 38% to 8% or less over the next year.

Cannon AFB DBFRC resources include:

– One licensed professional counselor
– One virtual child psychologist
– Two registered behavioral therapists
– One clinical nurse
– One case manager
– One child psychiatrist under the Circuit Rider program
– One developmental pediatrician under the Circuit Rider program

Dependents can contact their family health provider or pediatrician to request a referral to DBFRC services. For more information, please contact the DBFRC at (575) 904-4282.

* Does Targeted Care work?

From May to October 2023, the DHA implemented a Targeted Care pilot at 10 sites to test the approach. Across the sites, approximately 40% of help-seeking individuals were found to not require medical intervention or have a diagnosable condition and were vectored to other resources.

The pilot sites reported that 2,650 individuals were connected to mental health support services outside the clinic, freeing up about 8,000 appointments for patients requiring clinical services and expanding clinics’ ability to schedule follow-up appointments and episodic behavioral health therapy.

Less than 3% of the individuals who were vectored to external resources returned for specialty behavioral health services.

By optimizing support resources and streamlining access to care, the 27th SOMDG expects Targeted Care to help improve Air Commando quality of life, reduce mental health readiness impacts and promote a culture that encourages help seeking.

Targeted Care has already been deployed to several locations. The DHA is developing policy guidance to implement it at every military hospital and clinic throughout the Military Health System by 2025.

“Mental health IS health,” said Cermak. “It is no different than the broken leg you went to the ER for. Our mental health clinic and the various non-clinical providers across the base are a team, and they are here for YOU.”

Targeted Care is one of several 27th SOMDG medical initiatives implemented since 2023, including the Circuit Rider Program, virtual Mental Health Assessments and Periodic Health Assessments (VIPRR), the Behavioral Health Resources and Virtual Experience (BRAVE) initiative, a senior leader medical support summit and a newcomers’ Medical Right Start briefing program.

Cannon AFB Air Commandos seeking mental health care can begin the vectoring process by scheduling an appointment with the 27th SOMDG behavioral health clinic at (575) 784-1108.

If you or a loved one is experiencing thoughts of self-harm or suicide, you can confidentially call or text the National Suicide and Crisis Lifeline at 988.