Tricare policy changes: Hurting military families when help needed the most

We are at a pivotal point in time for our military community in terms of mental health. Increasing awareness and reducing stigma associated with mental health among service members and within the military community has been on the minds, and hearts of those within the leadership roles and within the mental health professional network for some time; from the recent CNN article “The Uncounted”, and the “Make the Pledge” campaign of Military Spouses of Strength and its partners.

However, this plight must not have reached those in charge of Tricare and VA policies. In 2011 policy changes were put in place that are to take effect in January of 2015. These changes affect mental health providers licensing requirements (removing the capacity for supervised mental health counselors as acceptable clinicians, and requiring that mental health providers for Tricare and the VA be CA-CREP certified), a full recap of requirements can be found here: https://www.hnfs.com/content/hnfs/home/tn/prov/bh/mhc_requirements.html. It should also be noted that Tricare is not the only federal entity that will begin following CACREP guidelines (the VA will also.) “Currently, there are only approximately 265 colleges and universities that are CACREP accredited, which constitutes only about ten to fifteen percent of ALL college and universities4`,” stated Dr. Ingrid S. Herrera Yee, AFI’s National Guard Military Spouse of the Year 2014.

This is not to attack the CA-CREP accreditation, but to question the timeliness of implementing such policies. During the course of these changes the military mental health professional community could potentially lose quality mental health care providers due to credentialing. For example, Harvard is not CACREP accredited, but anyone would be hard pressed to say that Harvard is not a quality program; however, under these new guidelines a Harvard educated mental health clinician would be unable to provide support to Tricare and VA patients.

Why at this point when mental health care is such a priority, is it time to change those requirements, making harder for those that are seeking care potentially increasing wait times as the pool of “qualified” mental health professionals will begin to diminish? While this Tricare policy change went into effect in 2011, it is not widely known to those within the military mental health professional networks.

As one mental health professional put, “Yes, moving towards national accreditation would be great, but grandfathering for already licensed folks and reciprocity especially for military spouses would be so helpful in the meantime. If those measures aren’t taken a lot of great licensed Counselors will have to leave the field and be able to provide services to those who need it most.”

And yet another mental health professional brings to light how these policy changes will affect the demand within the sector, “There is no way the grads from just CACREP schools would be able to meet the demand of that loss any time soon. It does sound like a great idea to move toward, but it would be unfair to force out seasoned professionals, not to mention unfair to the populations who really need to have access to those professionals. Grandfathering over the next decade at least is most certainly essential, January 2015 isn’t enough time to have enough licensed professionals to meet the demand.”

A DCOE-Psychological Health department report found that 1 million mental health supportive services were sought between 2001 and 2011. Additionally, there are approximately 22 veterans that commits suicide per day; that is 22 deaths too many. We lack the knowledge of what the military families are doing in terms of their mental health, because currently we have not formalized a plan in tracking military dependents (spouses, and children).

Were any of these numbers taken into consideration when policy changes were decided? Was the wait time considered that service members and families currently have before they can be seen by a provider? Currently, the average wait time for mental health care within the military community is to long- some waiting as long as weeks before they are able to see a provider; these new regulations will most likely negatively impact the wait time.

Amidst, the recent VA scandal being linked to veteran suicides coupled with these TriCare and VA policy changes we should wonder if those that are fighting for mental health care are really being heard.

Together we need to take a stand for those within the mental health profession, for those within the military community seeking mental health support, and demand an extended grandfathering period for the regulations to take effect.

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