greetings! this video will prepare you to administer the new dod deployment mental health assessments. force health protection and readiness, part of the office of the assistant secretary of defense for health affairs, has collaborated with the deployment health clinical center to develop an enhanced mental health assessment for use before and after deployments. this training material and a power point version are available for you to study and review as needed at:
http://fhpr.osd.mil/mha. the main goal of the new mental health assessment is to identify post-traumatic stress disorder (ptsd), depression, suicidal tendencies, and other mental health conditions, to determine if a solider, sailor, airman, marine or a coast guardsman is in need of a referral for further mental health assessment and care. after reviewing either the video or the power point training, you must successfully complete a post-test
evaluation and a course feedback questionnaire. you will then receive a certificate that confirms that you are now trained and certified to administer these mental health assessments. this training will specifically address -1. how to conduct a mental health assessment -2. how to provide feedback to the deployer regarding symptoms, and -3. how to respond if the assessment indicates risky alcohol use, depression, ptsd, or other mental health concerns.
you’ll learn when to refer a deployer for further evaluation or treatment, and how to identify and respond to situations that demand immediate clinical intervention. the provider section of the new mental health assessment requires that you have a “person to person†interaction with the deployer. it’s important to note that person to person can mean a face-to-face interview, a video telehealth interview, or talking over the phone. in conducting these assessments, it’s important to ensure privacy to create an environment of trust and confidentiality.
as you also know, it is essential to ensure that the deployer feels omfortable about disclosing personal information. let’s get to the specifics. the definition of deployment, the leadership responsibilities to ensure compliance with this new requirement, and the instructions and exemptions for a comprehensive deployment health program, are delineated in dod instruction 6490.03 called “deployment healthâ€, specifically section 2 on “applicability and scope,†and enclosure 4 on “deployment health activities.†further guidance was provided by the 2012 national defense authorization act section 702 and the february 2013
od instruction 6490.12 “mental health assessments for service members deployed in connection with a contingency operation.†it is important to note that these mental health assessments are required for all personnel who are deployed as part of contingency operation including service members in the reserve components. the new mental health assessments must be administered at 4 different time points, once before deployment and three times after return from deployment. these 4 time points coincide with well-established health assessments. the first mental health assessment must be administered within 120 days
of the scheduled start of deployment. the second mental health assessment must be conducted between 90 to 180 days after return from deployment and can coincide with the post-deployment health reassessment, or pdhra. the third and fourth mental health assessments should be administered between 181 days and 18 months, and between18 to 30 months post-deployment, respectively. what if a service member is deployed soon after return from a deployment, let’s say, for example, 6 months after returning from a previous deployment? in that case, the deployment mental health assessment cycle is reset
to the start and end dates of the new deployment. who can conduct these mental health assessments? in addition to licensed mental health providers, the mental health assessments may be performed by trained and certified: physicians, physician assistants, or nurse practitioners; advanced practice nurses, special forces medical sergeants, independent duty corpsmen, independent duty medical technicians, and independent health services technicians these non-mental health providers are considered trained and
certified to provide the assessments after completion of this training and passing the posttest questions. next, let’s talk about the components of the assessments. there are three stages to the mental health assessment process. the first and second stages are comprised of self-reported information from the deployer and the third is the person-to-person interview with a provider. let’s review the 3 stages in detail. the first stage occurs when the deployer reports his or her own
mental health symptoms by answering a series of questions. the deployer responds using automated questions on a computer or, in some situations, a paper version. these are the seven content areas covered by the self-report questions in stage 1 of the assessment. 1. major life stressors 2. mental health conditions 3. prescription and over-the-counter medications 4. alcohol use
5. posttraumatic stress disorder (ptsd) 6. depression 7. mental health concerns/questions two of these seven self-report areas, ptsd and depression, may require additional self-report assessment questions depending on the deployer’s responses during stage 1. if the self-report responses for the initial questions for ptsd or depression in stage 1 are positive, they will trigger additional screening questions in stage 2. these additional stage 2 questions
will gather more detailed information about the symptoms of ptsd and depression. so, before you interact with the deployer, you will be able to review the responses to the questions to determine the severity of ptsd and depression symptoms and how these symptoms are affecting his or her functioning. this new enhancement to the deployer’s self-report section will provide the in-depth information you need to determine whether a deployer needs further care. if the initial screening for ptsd and depression is negative, the deployer will not answer additional ptsd or depression
questions in stage 2, but will proceed directly to the stage 3 provider interview. stage 3 is the person-to-person interview, where you interact directly with the deployer to go over his or her answers from stages 1 and 2. this part of the assessment is your chance to clarify the deployer’s responses, to assess suicidal ideation and violence risk, to address specific mental health concerns, to provide reassurance and information, and/or to make a referral. since the majority of your time will be spent on stage 3,
let’s discuss some techniques that can help ensure that you conduct an effective interview with the deployer. from your own experience as a medical provider, you know how important it is to prepare in advance for any personal -interaction with a client or patient. this is even more important during the mental health assessment, since the deployer has already disclosed personal mental health symptoms, how those symptoms are affecting day-to-day life, and whether there are any other concerns.
so… make time to review the deployer’s responses and scores to the self-report questions in stage 1 and stage 2 prior to the person-to-person interview. if you do not have access to automated scoring of the stage 2 questions, please spend a few minutes to score them manually. it is absolutely essential that you create a private, supportive atmosphere in which the deployer feels comfortable disclosing sensitive, personal information. the deployer may also disclose mental health concerns in the person-to-person
interview despite not reporting them in the responses to the survey questions. so, pay close attention to this aspect of stage 3. here are some useful strategies for enhancing rapport during your interview. preparation for the ‘person-to-person’ interview starts with personal awareness. be aware of your own state of mind and your own nonverbal signals. what is your attitude toward deployment? toward the unit? toward the deployer? in fact, what is your attitude toward your own role in the military? consider your nonverbal behavior. we all know that negative attitudes,
fatigue, and other personal concerns can adversely affect nonverbal communication. you want to definitely make sure you protect against interruptions and distractions. if you’re interrupted and not providing 100% attention to your patient, obviously that patient will probably return less than100% attention to you and the process. open the dialogue by stating the purpose of the interview. you could say something like: “we all know that deployment has life changing experiences involved. this visit is to
check in with you to see how you are doing, to discuss any mental health concerns you might have, and to give you an opportunity to raise questions.†ask about social support: “is there anyone you can talk to about your deployment, or other aspects of your life?†provide reassurance, feedback and discuss treatment options, for example: “in most cases, these symptoms get better over time,†or, “the good news is that we have several proven treatments for the kinds of symptoms you are experiencing. let me go over
some of the options you have for getting better†foster a therapeutic alliance: “i can provide you information on resources we have available.†ask about stage 1 and stage 2 responses. use this opportunity to clarify the deployer’s responses, to show empathy, express concern, to affirm, to inform, and to inquire. for example, “you checked you are having sleep problems, how do you deal with that? you said you are having nightmares. how do you deal with that situation? you also said some of these symptoms are causing difficulty
in your day to day life. how do you deal with that? how is your relationship with your children? when wrapping up the interview, you want to summarize your understanding of the deployer’s concerns. for example, “it sounds like you are having a difficult time because of some of the symptoms you mentioned. let’s talk about some things that we can do to help…†if there are no serious issues, perhaps your main reason for the visit is to normalize common concerns.
for example, you say “many people have reported similar experiences after being back from a deployment.†talking about it can help mitigate some of the problems you are having.†if there are concerns that require follow-up, get the deployer’s feedback on referral recommendations. for example, say “i’d like to recommend that you see a specialist for further assessment and follow-up; what do you think of that plan?†finally, of course, be sure to thank the deployer for their service!
now, let’s walk through the specific areas covered in the mental health assessment, the member’s responses to the stage 1 and stage 2 questions, and your interview in stage 3. the first self-report question in stage 1 asks about major life stressors in the past month. there’s a free text field so the deployer can provide details. as you know, major life stressors can trigger mental health symptoms. the self-report item about major life stressors is included to identify non-combat-related concerns such as marital, legal,
disciplinary, or financial problems. if the deployer endorsed “yes†to the question about life stressors, then in the stage 3 provider interview, elucidate details, and consider a referral for mental health care if the deployer is experiencing significant distress or significant impairment in functioning. the next question asks about a past history of any mental health care for conditions such as for ptsd or depression in the past year. there’s a free text field here also so the deployer can
provide details. make sure to clarify if the deployer is currently in treatment the next question is about prescription medications or over the counter supplements the deployer might be taking currently, such as for sleep or pain, or for mental health problems. again, a free text field is provided for additional details. in the stage 3 interview, you will review the information provided by the deployer, elicit details and clarify responses as indicated…so, if a deployer answers “yes,†to the medication use,
ask about dosage, frequency, duration, side effects etc. for a deployer currently receiving mental health treatment, you could ask whether he or she is satisfied with the current treatment regimen. also, inquire whether he or she is continuing to take medications as prescribed or whether there are any concerns or side effects with the medications. on’t forget to ask about over-the-counter herbal preparations and supplements, including use of “energy drinks,†diet supplements, and excessive consumption of coffee
or other caffeinated beverages. the next section deals with screening for risky alcohol use. the alcohol use screening tool, called the audit c, is a valid and reliable scale for detecting heavy drinking and/or active alcohol abuse or dependence in the primary care setting. it consists of three questions, each scored from 0-4. the goal is to identify risky drinking patterns before they become a persistent problem. the audit c score will determine what, if any, action
you will take regarding the deployer’s alcohol use. the first of three questions asks about the frequency of alcohol use. the second question asks about the quantity of alcohol consumed on a typical day when drinking. the final question asks about binge drinking. to get a total audit c severity score, sum the totals from the columns. a negative screen is a score of 4 or less for men and 3 or less for women. for deployers who score in this range, no action or intervention is necessary, except to advise the deployer
to restrict their drinking to below the recommended limits. we will discuss what the recommended drinking limits are shortly. it’s important to note that: a positive screening score of more than eight indicates potential problem drinking, and the deployer would likely benefit from both a brief educational intervention and a recommendation for further evaluation or treatment. what about deployers who have scores that fall in the middle range, specifically, a score of 5 to 7 for men or 4 to 7 for women?
this mid-range score raises the possibility that the deployer could be engaging in risky alcohol use. to confirm if this is the case, you should assess the deployer’s current drinking level in greater detail and conduct a brief educational intervention if the deployer is indeed at risk for adverse consequences in the future. for an in-depth assessment of the deployer’s current drinking level, ask two questions: “how many standard drinks do you drink per week?†and,
“how many standard drinks do you drink on any single occasion?†to review, a standard drink consists of 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of distilled spirits, such as vodka, gin or whiskey. for men, the maximum weekly drinking limit is 14 drinks, with no more than four on any one occasion. for women, the weekly limit is 7, with no more than three drinks on any one occasion. for those whose audit-c scores fall in this middle range
and who are drinking above the recommended drinking limits, you should conduct a brief educational intervention. the suggested steps are outlined under the acronym b-r-i-e-f. bring attention to elevated levels of drinking, recommend limiting use or abstaining from alcohol, inform about the ill effects of alcohol on health, explore the option of selecting an appropriate drinking goal for the deployer, and follow-up and refer for specialty treatment if indicated.
let’s review each of the steps in this brief intervention in a little more detail. b stands for bring attention to elevated levels of drinking. one way to do this is to use this chart to communicate exactly how the deployer’s drinking habits compare with his or her peers. providing normative feedback has been shown to lead to reductions in heavy drinkers. normative data for audit-c scores for men and women deployers of different age ranges are available in the appendix section of the training website: http://fhpr.osd.mil/mha
bringing attention to the deployer’s level of drinking should not be accusatory – you can simply say, “your level of drinking is in a high range compared to your peers – what are your thoughts about this?†presenting this card may start an open-ended discussion about the deployer’s drinking, which gives you an opportunity to walk through the other steps of a brief intervention. r is for recommend limiting or abstaining from alcohol use, so you might say, “as a health care provider, i suggest you
don’t drink more than the recommended limits. i is for inform. inform the deployer about the negative effects of alcohol on health. for example, you can point out alcohol’s disruptive effect on sleep or how it can make depressive symptoms worse. e stands for explore in choosing a drinking goal, such as, “if you were to cut back on your drinking, what would be a reasonable limit for you?†f is for follow-up and referral for specialty treatment if indicated.
for example, if the deployer has a history of alcohol abuse or alcohol related problems, point out that their current level of alcohol use indicates they should receive a more thorough alcohol assessment and possibly intervention. based on the audit-c score and your assessment of the deployer’s alcohol current alcohol use, apply the intervention matrix to determine course of action. for example, if the audit-c score for a male deployer is between 5 and 7, and the deployer’s current alcohol use exceeds recommended limits, consider referral to specialty care
in addition to b-r-i-e-f counseling. if drinking does turn out to be a serious concern, then recommend that the deployer seek specialty care for the management of this problem. for example, a deployer with prior treatment for alcohol use disorder who is currently engaging in risky drinking, or a deployer with an audit-c score > 8, would require a referral for additional care. in accordance with dodi 1010.6, further patient assessment by those trained in alcohol and substance use assessment and referral will determine the need for rehabilitation services on a case-by-case basis.
the results of this follow-up assessment may result in alcohol education for the deployer, which does not necessarily require command notification. however, if the assessment results in a diagnosis of alcohol dependence or abuse, residential or non-residential treatment may be indicated, which would require command notification and coordination. the next series of questions assesses ptsd symptoms. in stage 1, the deployer fills out the primary care-ptsd screen. the 4-item pc-ptsd is a valid and reliable tool to screen for ptsd in primary care. the questions refer to symptoms that a deployer may have experienced in the past month.
if 2 or more symptoms in the primary care ptsd scale are marked ‘yes’, it is a positive screen. the deployer is then prompted to complete a more detailed set of questions regarding ptsd symptoms using the ptsd checklist, in stage 2. to review, stage 2 applies only to deployers who screen positive for either ptsd or depression in stage 1. during stage 2, the deployer is required to answer more detailed questions addressing ptsd and depression symptoms and to indicate if these symptoms are affecting his or her functioning. this additional information
will help you make an informed decision about whether the deployer needs further mental health assessment and care. if the deployer completes the assessment using an automated it platform, the additional stage 2 questions will automatically pop up on the screen if stage 1 questions for ptsd or depression are positive. if the stage 1 questions are positive and the stage 2 questions weren’t completed, you will have to provide the additional questions to the deployer. so let’s say the deployer screens positive for ptsd by answering
‘yes’ to two or more questions on the primary care ptsd screener. the deployer will then fill out the ptsd checklist-civilian version (pcl-c). the pcl-c is a valid and reliable questionnaire comprised of the 17 symptoms of ptsd. deployer responses can range from “not at all†to “extremely.†the reason for using the civilian version is to inquire about traumas related to both combat and non-combat stressors, such as sexual assault. the functional impairment question inquires about the extent to which the reported ptsd symptoms have made it difficult for
the deployer to do assigned work, take care of things at home, or get along with other people. now that the deployer has provided the additional information in stage 2, your role in stage 3 is to add up the responses to obtain a total score, inquire about and clarify the symptoms in the deployer self-report section, make a decision about the clinical significance of the ptsd symptoms, and assess the need for a referral for further mental health care. if you have an automated it platform, it will sum the individual pcl-c scores and give you the total score, which is a reflection
of the severity of deployer's ptsd symptoms. if the deployer fills out the pcl manually, here is how you score it. step one: add up the circled numbers in each of the four columns. step two: sum the values from the columns to obtain a total score. the question about the degree to which a deployer’s ptsd and depressive symptoms are affecting his or her functioning at home, work, and in social relationships provides valuable clues to help you determine the clinical significance of the deployer’s reported symptoms. please consider both the severity of the ptsd symptoms (pcl score)
and the degree of functional impairment when making a decision to refer to mental health care. this table summarizes the different options available for deployers with mild, moderate, and severe ptsd symptoms with normal or significant difficulty functioning. let’s go through the different categories: a score <30 is consistent with sub-threshold ptsd symptoms, and no intervention is indicated. you can reassure the deployer by saying “the symptoms that you are experiencing are quite common after combat. most of the time, these symptoms get better on their own. however,
if you find that it is not getting better or it begins to interfere with your functioning, please contact your provider.†a pcl score of 30-39 indicates mild ptsd symptoms and 40-49 moderate ptsd symptoms. if along with these symptoms, the deployer is also finding it very difficult to function at work, home or in social relationships, then the ptsd symptoms are most likely clinically significant, and this deployer could benefit from further mental health assessment and care. if the deployer is functioning well despite mild or moderate ptsd symptoms,
reassure the deployer, provide literature on ptsd, encourage self-management activity (handouts are available at: http://www.pdhealth.mil), and counsel the deployer to seek help if symptoms worsen. a total score >50 suggests severe ptsd symptoms, and the deployer will benefit from further mental health assessment and care. now let’s discuss the items that screen for depression. the approach to assessing depressive symptoms is very similar to assessing ptsd – the main difference is that the patient health questionnaire, or phq-2, is used for the initial stage 1
screen, and the phq-8 is used for exploring additional details of depressive symptoms in stage 2. the phq-2 is a valid and reliable screening tool for depression in primary care, and inquires about the presence of sad mood and decreased interest and pleasure over the past two weeks. if the deployer endorses “more than half the days†or “nearly every day†on either question, the result is a positive screen. the deployer is then required in stage 2 to complete 6 additional questions detailing his or her depressive symptoms
and degree of functional impairment. the phq-8 is modified version of the phq-9. the main difference between the phq-8 and 9 is that the last question, the question about suicide has been omitted. there’s a very important reason for this. it ensures that questions about suicide are addressed during the person-to-person interview, which allows you to clarify any positive responses and intervene if necessary. this allows the clinician to determine if the deployer is a suicide risk and, if so, allows for immediate interaction and
further referral, obviously. now depressive symptoms are important to determine during this interview, during this process, and the degree to which these symptoms affect work, affect home, social interactions will kind of determine how quickly services need to be sought for this deployer. now that the deployer has provided the additional information in stage 2, your role in stage 3 is to review and add up the responses to obtain a total score, to inquire about and clarify the symptoms the deployer is experiencing, and to make a decision
about the clinical significance of the depressive symptoms and whether a referral for further mental health assessment and care is needed. if the assessment is computerized, an it application will automatically sum the individual phq-8 scores and give you the total score, which is a reflection of the severity of depression symptoms. if the deployer fills out the phq-8 manually, this is how you score it. step one: add up the circled numbers in each of the columns. step two: sum the values from the columns to obtain a total score. the decision about whether to refer the deployer for mental
health care should be based on both the severity of symptoms as reflected in the phq-8 score, and the difficulty functioning in work, home and social life. this table summarizes the different options available for deployers with mild, moderate, and severe depressive symptoms with normal or significant difficulty functioning. let’s go through the different categories. a score between 1-4 indicates no depressive symptoms and does require any intervention. a score between 5 and 9 is
consistent with sub-threshold depressive symptoms. a score of 10-14 indicates mild depressive symptoms, 15-18 moderate depressive symptoms, and 19-24 severe depressive symptoms. if the deployer reports that the depressive symptoms are making it “very†difficult or “extremely†difficult to function in their work, home or social life, then the depressive symptoms are most likely clinically significant, and this deployer would benefit from a mental health referral. if the deployer is functioning well despite sub-threshold or mild
epressive symptoms (i.e. a score between 5-14), then reassure the deployer, provide literature on depression, encourage self-management activity (handouts are available at: http://www.pdhealth.mil), and advise him or her to seek help if the symptoms worsen. for moderate depressive symptoms and normal functioning, consider a referral in addition to education about depression. if the total score is between19 and 24, it suggests severe depressive symptoms, and the deployer would benefit from further mental health assessment and care in addition to education about depression.
now that we’ve covered the major clinical areas assessed in the self-report, let’s finish discussing the other self-report questions before moving on to the rest of the person-to-person interview. the final two self-report questions in stage 1 ask if the deployer is interested in receiving information or assistance for a stress, emotional or alcohol concern or for a family or relationship concern. in your interview, again, you will have the opportunity to probe these concerns further and consider the need for a referral, if indicated. the next section in the stage 3 provider interview focuses on suicide
and violence risk assessment. regarding suicide risk, there is an important question that you must ask verbatim. “over the past month, have you been bothered by thoughts that you would be better off dead or of hurting yourself in some way?†if the answer is “yes,†you must do a suicide risk assessment. first, try to determine whether the suicidal thoughts are passive or active. “passive†thoughts are along the lines of “i’d be better off dead,†as opposed to “active†suicidal ideation which involves thoughts of hurting oneself or ending one’s life.
if the deployer has active thoughts of hurting himself or herself please use the four-step process for an in-depth assessment of risk. an easy way to remember the detailed assessment is by using four ps: plan, probability, preventive factors, and past history. the first p is the plan. ask if he or she has a plan for ending their life and ask for details, including method, intent, lethality, access to means of hurting themselves, and preparations if any. if there is a
distinct plan, this indicates a higher risk for suicide. the second p is probablity. estimate the probability that the deployer might follow through. the third p is preventive factors. ascertain what, if any, preventive factors might stop them from harming themselves. these could include things like considering the effect on their families, or perhaps their religious beliefs. the fourth p is the past. be sure to ask if the deployer has made a suicide attempt in the past, and if so, ask for the details about that past attempt.
past suicide attempts increase the risk for further attempts. review other factors that increase the risk for suicide, such as: interpersonal conflicts, current alcohol or substance use, financial stress, or legal or disciplinary problems. make sure to elicit details for positive responses. if the deployer has an active desire to complete suicide combined with other risk factors, such as absence of social support, current alcohol abuse, and significant financial difficulties, this is an emergency situation, meaning you must arrange for an
immediate consultation with a mental health provider. you will need to ensure that the deployer is accompanied to an emergency room or mental health facility. you also have a duty to inform the deployer’s commanding officer. if the deployer displays passive suicidal ideation, but denies an active plan, arrange for an urgent mental health referral and advise the deployer what to do in a crisis situation. the process for evaluating the risk of violence is similar to that for suicide. start by asking if the deployer: “over the past month,
have you had thoughts or concerns that you might hurt or lose control with another person?†if the answer is yes, find out if the anger if directed at a specific person. if there is a target, try to determine how likely the deployer is to follow through if the situation is not resolved. if there is a specific plan, probe for details including intent. use this information to formulate a clinical decision about current risk to others. if the deployer admitted thoughts or concerns about hurting someone, but in
exploring the possible plan or intent you determined the member was not a risk, you would need to provide a brief explanation of your decision. if there is a specific target, and the threat to that individual or group is real, ensure that the deployer receives an emergency mental health consultation. you also have a duty and a legal obligation to warn the target, alert law enforcement, and inform the deployer’s commanding officer in accordance with dodi 6490.4.
all of this must be done immediately. if there is no definite plan, make an expedited mental health referral for further evaluation or treatment, advise the deployer what to do in a crisis situation. suicidal ideation and interpersonal aggressive ideation can be difficult topics to probe and discuss. we hope these guidelines will give you the information you need to address the topics effectively and with confidence. in the few situations when urgent intervention is necessary,
your role will be crucial in ensuring the safety of the deployer and perhaps the safety of others. conclude the session by offering your overall clinical impressions, making recommendations, and pointing the deployer to other sources of support or information. an impression might be something like: “it looks like your depression symptoms might be quite severe and are affecting your ability to work.†in that case, you might recommend that the deployer
consult with their primary care provider or a mental health provider for a thorough evaluation. please ensure that you mark the appropriate box on the assessment form to record your referral. make sure the deployer knows that there are good options for dealing with any mental health symptoms or concerns, and that help is always available. options could include seeing a mental health professional, turning to a chaplain for counsel, or communicating more openly with a spouse.
the specific resources may vary according to the reported symptoms, the deployer’s branch of service and duty status, so try to identify the specific resources that apply. make sure you are aware of local resources before you start to administer the mental health assessment. one important resource for many deployers is the intransition program, which is a one-on-one telephonic coaching service that supports deployers
until they receive recommended mental health care. this program is designed for active duty personnel going through a permanent change of station or temporary active duty, or for guard, reserve or separating deployers who may benefit from va, tricare, or community mental health care. you can also explain how the deployer can find the appropriate resources. by policy, you are required to document the
results of the mental health assessment in the medical record. there may also be other service-specific policies you will need to follow for documenting and tracking the results of the mental health assessment. finally, just as the deployers have resources available to them, you have resources that can help guide you through the mental health assessment process and advise deployers effectively. these resources can be found on the website listed here and include useful information, such as:
-- alcohol brief intervention normative feedback cards; -- educational information on depression -and ptsd; -- self-management worksheets for effective self-care of mental health symptoms; and, -- the intransition program. we recognize that focusing so intensively on mental health concerns might be new to you. however, your clinical experience is a solid foundation for developing these new skills.
congratulations, you have reviewed all of the required material for the training to administer dod deployment mental health assessments. please complete the post-test to obtain your certificate and your continuing education credit. thank you for your support of our deployers and your dedication to helping to ensure their health and well-being.
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