HQMC Behavioral Health Branch Keita Franklin, PhD, LCSW Behavioral Health Branch Head Keita.Franklin@usmc.mil

1. HQMC Behavioral Health Branch Keita Franklin, PhD, LCSW Behavioral Health Branch Head Keita.Franklin@usmc.mil

2. MF Mission and Vision Mission “Keeping faith with our Marines and their families.” Vision Highly resilient, program savvy Marines and Families, robustly equipped with the services and tools they need to meet an era of persistent conflict as well as the challenges of day-to-day life in the 21st Century; especially during transition periods associated with mission, life and career events.

3. MF Tenets Do the right thing. In all that we do, we are professionals and our service shall be characterized by the highest standards of professional ethics. Live within our means. Every dollar spent must result in superior program support and measurable effectiveness. Transparency. Our actions are focused and attentive but open to question, inspection, or audit and cooperation, collaboration and sharing is highly encouraged. Strengthen relationships. Wounded Warrior Regiment, Marine Corps Community Services, and Marine and Family Programs depend on the organizational strengths and contributions of many agencies. Marines and their families are served best by full partnerships.

4. Background USMC Suicides Sexual Assaults Family Violence Positive Urinalysis Child Maltreatment • CPG, Priority #4 Task – Integrate Behavioral Health Efforts • Five Behavioral Health Programs include; Family Advocacy, Sexual Assault Prevention and Response, Combat Operational Stress Control, Substance Abuse and Suicide Prevention

5. Stove-piped Programs – Old Way Supported Programs Training Requirements Training Requirements Supported Programs Coordination Training Goals Strategic Direction Funding Training Goals Strategic Direction Funding Training Goals Strategic Direction Funding

6. Integrated Behavioral Health Programs – New Way • Priority #4 Task - Integrate BH efforts • Program integration, allocation of resources, strategic planning, and communication with commanders Programs Outputs Inputs • Universal Training • Family Advocacy IDC Rollout • Marine Resiliency Study • Peer to Peer Training • Never Leave a Marine Behind • OSCAR • Take a Stand Strategic Planning and Communication Unified Policy Common Vision Funding Evidence Based Practices Suicide Prevention Substance Abuse Prev Family Advocacy Sexual Assault Reporting and Prevention Combat and Operational Stress Control

7. Integrated Behavioral Health Programs – New Way • Priority #4 Task - Integrate BH efforts • Program integration, allocation of resources, strategic planning, and communication with commanders Outcomes: • Better Support to the Commander • Coordinated training requirements • Eliminated redundancies • Uncovered gaps • Validated practices • Operational efficiencies

8. Other BH Initiatives • Free educational tools and products for Marines and families • Standardizes behavioral health messaging • Conveys back to stakeholders what information is important to whom • Currently over 80K materials distributed • Additional Behavioral Health materials forthcoming • An evaluation of the BHIN found: • 85% of the participants indicated that the BHIN website was extremely useful in meeting their COSC needs • 40% ordered materials for themselves • 32% ordered information for their command/workplace • 28% ordered for fellow Marines

9. Realities • Resources/Funding • Staffing • Updating and Timely Policy • Operational Tempo • Mission creep into other HQMC programs and activities

10. Way-Forward Establish Behavioral Health Program (BHP) and Structure. The Marine Corps BHP and structure will be created to serve as a single point of advocacy to meet the dynamically changing and complex needs of Marines and their families. Hire and Grow a Ready Workforce. Offering staff a continuum of opportunities for training and knowledge development is a critical component for the future behavioral health capabilities of the Corps. Establish Program Oversight, Accountability and Transparency. The BHP will be accountable to Marine Corps leadership and the needs of Marines and their families.

11. Way-Forward Adopt, Implement and Sustain Evidence Practices. Evidence based approaches build trust with commanders by ensuring Marines and their families are offered the most up-to-date, empirically supported prevention and treatment practices available. Implement the Institute of Medicine Mental (IOM) Health Intervention Spectrum for Mental Health Disorders. The IOM Mental Health Intervention Spectrum for Mental Health Disorders provides an appropriate framework for integrating behavioral health elements, as it complements the current Marine Corps Stress Continuum.

12. Program Structure Establish Behavioral Health Program (BHP) and Structure. The Marine Corps BHP and structure will be created to serve as a single point of advocacy to meet the dynamically changing and complex needs of Marines and their families. • Staffing issues • OCO until shifted into baseline • On-going analysis – documented needs • HQ staffing models that reinforce full complement of services for the field and higher HQ • Installation staffing models that are scalable and on par with the needs of clients

13. Workforce Hire and Grow a Ready Workforce. Offering staff a continuum of opportunities for training and knowledge development is a critical component for the future behavioral health capabilities of the Corps. • Efforts well underway • Training Needs Assessment • Informal inquiry and dialogue • Cognitive Processing Therapy • Parent-Child-Interaction Therapy • PRIME Training • COSC/Suicide/SAPR/FAP Conference • Trauma Informed Care • Victim Conference

14. Program Efforts Establish Program Oversight, Accountability and Transparency. The BHP will be accountable to Marine Corps leadership and the needs of Marines and their families. Early efforts include: - Improved Accreditation Processes - Policy • MF Newsletter • Weekly updates • Share point • VTC’s • OPT’s • BHAC

15. Evidence Based Practice Adopt, Implement and Sustain Evidence Practices. Evidence based approaches build trust with commanders by ensuring Marines and their families are offered the most up-to-date, empirically supported prevention and treatment practices available. • Begins with IOM model • IDC Case Review processes • Peer-to-Peer Models • NLMB • Take a Stand • PCIT • OSCAR • FAP Prevention Curriculums

16. Future Operations • IOM Health Intervention Spectrum for Mental Health Disorders Continuum • Behavioral Health Advisory Committee (BHAC) • Research / Program Evaluation • Behavioral Health Conferences • Behavioral Health Case Management System • Universal Training

17. Prevention Continuum An Evidence Based Framework…. READY REACTING INJURED ILL BUMED USMC and BUMED USMC STRESS CONTINUUM

18. Behavioral Health Advisory Committee • PURPOSE • Advise MF on behavioral health programs and initiatives • Focus on; • gaps, • duplication of effort, • best practices in research and application VOTING MEMBERS EX OFFICIO • Dir, MF (chair) • TMO (vice chair) • Chaplain of the Marine Corps • Exec Dep, TECOM • MARFORCOM (Col) • MARFORPAC (Col) • MEFs (Col) • MFR (Col) • Dir, SD (Col) • SgtMaj, MF • BH Branch Hd • MF Counsel • DCOE • NHRC • Recorder

19. Behavioral Health Advisory Committee • ACTIONS • Synchronize / integrate behavioral health efforts • Review / develop / ID research & future operations requirements • Propose opportunities for coordinated education / training efforts • Examine requirements for sustainment • Address ‘confidentiality vs. engaged leadership’ • Address stigma issues • Clarify consequences of seeking mental health care • Share outcomes across systems • METHODOLOGY • Four meetings / year • Meeting minutes reported to Executive Force Preservation Board

20. Future Operations • Behavioral Health Conferences • focus on improving services to Marines and their families • sharing of evidence-based practices • improve integration efforts • Behavioral Health Case Management System • executive leadership support • will share information (when appropriate) between programs • will assist integration efforts • hiring an IT specialist to assist • Universal Training • based on IOM model • based on the successes of Never Leave a Marine Behind, OSCAR and Take a Stand training • signed contract in Sept 11

21. Point of Contact Keita Franklin, PhD, LCSW Behavioral Health Branch Head Keita.Franklin@usmc.mil