NORTH CAROLINA NATIONAL GUARD INTEGRATED BEHAVIORAL HEALTH SYSTEM

1. NORTH CAROLINA NATIONAL GUARD INTEGRATED BEHAVIORAL HEALTH SYSTEM “Taking Care of Our Own”

2. CURRENT SITUATION • UNPRECEDENTED RISE IN SUICIDE ARMY WIDE • Army-wide, June 2010 highest month of Soldier suicides to date • In Reserve Component suicide trends continue upward • 50 suicides Guard-wide, compared to 37 at same point last year (27 of the 50 never deployed) Source: NGB-G1 as of 15 June 2010 • Highest risk demographic: • < 24 years of age • never deployed • < 4 years of service

3. Estimated unreported suicides: 1 (CDC estimates 5% to 25% more actual suicides above reported number) Estimated non-fatal suicidal behaviors: 160 to 500 (CDC estimates 40 to 100 times greater than number of suicides) Number of people affected: Each suicidal behavior may affect a few or a very large number CURRENT SITUATION CONTINUED NCNG Region: CY 2010 Year: NCNG Population: 4 Reported suicides: Unknown People with thoughts of suicide:

4. CURRENT SITUATION CONTINUED TRENDING FACTORS IN CRISES: RELATIONSHIPS divorce, domestic violence and child abuse EMPLOYMENT approx 32% unemployment nationwide in National Guard (NGB) vets aged 18-24 have unemployment rate of 21.1%, up from 14.1% in 2008, and higher than non-vets the same age (16.6%) – (Dept of Labor) SUBSTANCE ABUSE Emergency room visits for prescription drug abuse is up 400% from 12 months ago (DHHS DD/MH/SA)

5. CURRENT SITUATION CONTINUED • High number of behavioral health issues: 50% of participants had reported behavioral health issues at 3 month PDHRA (DMSS 2007) • Over 650 identified from recently redeployed units on high-risk list • Averaging 3 crises/week in NCNG • “While Army policy and processes are fundamentally sound, gaps allow soldiers to exploit or slip through the current system… There is a requirement to improve integration of surveillance, detection and accountability.” • Army Health Promotion, Risk Reduction & Suicide Prevention Report July 2010

6. NCNG Integrated Behavioral Health System (Intake/Referral/Case Management) BH Clinicians Command SARC Family Programs Chaplains DPH 24/7 800 # answered by Behavioral Health Clinicians PTO EAP MFLCs SPP TAA EXTERNAL AGENCIES SOS BH Case Managers Specific to Region of Soldier’s Location Casualty OPS

7. EMBEDDED LOCATIONS STORE-FRONT FAC Behavioral Health (BH) Positions Currently Funded • Asheville BH Clinician WEST • Greensboro BH Clinician CENTRAL/WEST • Greenville BH Clinician CENTRAL/EAST • Wilmington BH Clinician EAST • Behavioral Health Case Manager WEST • Behavioral Health Case Manager EAST

8. EMBEDDED LOCATIONS STORE-FRONT FAC Behavioral Health (BH) Positions Proposed for Phase 2 Funding • Raleigh BH Clinician CENTRAL/EAST • Charlotte BH Clinician CENTRAL/WEST • Kannapolis BH Clinician CENTRAL/WEST • Lenoir BH Clinician WEST • Behavioral Health Case Manager CENTRAL

9. PROGRAM BENEFITS • SO WHAT? • NCNG is the first NG state to embed full time BH Clinicians (NCNG Psychological Services Section) • 800 number provides easy access into the system • 24/7/365 access for command consultations • 24/7/365 rapid access for Service Members and Families to qualified assessment and appropriate referral • Triage-based intake and appointment scheduling available with NCNG Psychological Services Section • Service Members have multiple options for entry into a non-retribution and confidential environment for services

10. PROGRAM BENEFITS CONTINUED • SO WHAT? (CONTINUED) • Behavioral Health Case Management provides outreach and follow-up: • ensuring comprehensive SM care • strengthening relationships with external partners • System provides enhanced visibility of NCNG behavioral healthcare needs and improved common operating picture • System is designed to prevent medical crises. • System will increase appropriate command communications in “need-to-know” situations.

11. NORTH CAROLINA NATIONAL GUARD INTEGRATED BEHAVIORAL HEALTH SYSTEM • CONCLUSION • AND • QUESTIONS