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Telehealth, Virtual Counseling Available to Soldiers

APRIL 14, 2020 – After the Defense Department told non-essential personnel to remain in their residences to prevent the spread of coronavirus last month, many Soldiers found themselves in unfamiliar territory: working from home for the first time.

Teleworking brought challenges many Soldiers had not faced before, including separation from their units and commanders. Col. Dennis Sarmiento, psychiatrist and chief of the Behavioral Health Division at U.S. Army Medical Command, said Soldiers working virtually from their homes must establish consistent lines of communication, achievable goals, and some structure to adjust to current conditions.

The DOD’s telehealth and virtual clinical care services provided options for Soldiers seeking care prior to the spread of COVID-19. Now virtual counseling and online treatment have become the primary options for those seeking and sustaining continuity of behavioral health care.

Virtual treatment requests have spiked significantly since the DOD order went public last month, said Dr. Charles Hoge, psychiatrist and senior scientist at the Office of the Surgeon General.

“At no time in our history have we had to ramp up telehealth this quickly for this many patients,” Hoge said. Comparative studies have shown that telehealth services have proven to be as effective as face-to-face sessions.

Some face-to-face services remain available, including emergency care for behavioral health emergencies such as Soldiers contemplating suicide. Certain types of care that cannot be achieved from a distance also will be available, Sarmiento said. The availability of these services depends on individual military health facilities and the needs of the individual.

In addition to navigating assigned duties and responsibilities physically distanced from their units, Soldiers also must filter through inconsistent information dispersed from media outlets and local government, Sarmiento said.

“We acknowledge that there is increased frustration with the isolation,” he said.

“For some populations, there may be an increase in anxiety, there may be an increase of depression, but we want to ensure that the information gets out that access to care is still available, it just may not be face-to-face.”

Adding additional strain, some Soldiers who have children must now manage the dual role of full-time Soldier while acting as homeschool teachers for their children, most of whom have also been ordered to remain home with school closures. The dual role can be a curveball for some Soldiers, but Sarmiento said that consistent communication with the chain of command and maintaining a realistic schedule can help manage that challenge.

Soldiers who homeschool their children should try to establish a schedule with assigned times for their children’s education and for work. Frequent communication with units and discussing a Soldier’s limitations can help alleviate the burden of the dual responsibility.

“The individual has to know themselves and they have to be able to connect with others on their team,” Sarmiento said. “And recruit their help if they’re having difficulties in terms of managing the schedule, managing the mission.”

Soldiers who have worked remotely on deployments and in limited access locations develop unique communication skills, Sarmiento said. Under the current home restrictions, however, Soldiers may need to develop a new skillset, including being more adept with social media and online networking.

Sarmiento, who served as an Armor officer earlier in his Army career, said that the transition may not be as daunting as it seems, as many Soldiers can adapt to working without teammates nearby.

“It’s really all about discipline, setting a battle rhythm, and checking on your wingman” Sarmiento said. “Many types of combat units train to fight on and over wide areas of terrain, and many troops are accustomed to operating in a distributed fashion, connected by intercom, radio, or other digital means.”

A regular schedule for activity, nutrition, rest, and work tasks can help Soldiers maintain their focus. Commanders can set scheduled contact times through text, phone calls or video conferencing to maintain regular contact with Soldiers, he said.

Sarmiento noted that video conferencing may be preferable when communicating with new troops, as visual non-verbal cues can help inform leaders on Soldiers’ well-being. These cues include observing the appearance of a Soldier’s quarters, whether they maintain proper hygiene or if they appear tired and lacking rest.

The most effective communication tools depends on the unit’s needs and the relationships between commanders, supervisors and their troops, Sarmiento said.

Hoge said that the methods for battling depression and anxiety remain the same as they would prior to the pandemic, but they take increased importance in the current conditions. Getting regular exercise, sufficient rest, eating healthy, maintaining adequate hydration, and avoiding excessive alcohol use can help prevent depression. And Sarmiento reminds Soldiers they can still turn to leadership for help.

“I think we can learn from others and each other,” Sarmiento said. “I think this is where leadership at every echelon has a key role in sharing best practices and ensuring no Soldier, although some may be isolated, is never alone.”

By Joseph Lacdan, Army News Service

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