Delivery of high-quality behavioral health (BH) care is essential to the readiness of the U.S. armed forces and their families. Virtual behavioral health (VBH) care expanded during the COVID-19 pandemic and could support BH care delivery in the future. The authors examined trends in the use of VBH care for U.S. Army soldiers and their spouses from prior to the pandemic through March 2022 and surveyed soldiers about their perceptions of VBH care.

Virtual Behavioral Health for Army Soldiers

Soldier Perspectives and Patterns of Treatment

Kimberly A. Hepner, Joshua Breslau, Jessica L. Sousa, Carol P. Roth, Teague Ruder, Isabelle González, Cheryl K. Montemayor, Beth Ann Griffin

ResearchPublished Sep 19, 2023

Delivery of high-quality behavioral health (BH) care is essential to supporting the readiness of the U.S. armed forces and their families. The coronavirus disease 2019 (COVID-19) pandemic led to a dramatic expansion of virtual behavioral health (VBH) care: remote patient access to BH care using technology such as a computer or cellular phone. The U.S. Army asked RAND Arroyo Center to examine the use of VBH to inform recommendations on the role of VBH care in the future of BH care in the Military Health System.

The authors analyzed administrative data on VBH and in-person BH care from prior to the pandemic through March 2022 and surveyed soldiers who received BH care to assess their perceptions of VBH care. Administrative data analyses showed that direct care providers were less likely to deliver VBH care than private-sector providers and relied heavily on audio rather than video VBH. In addition, soldiers who received VBH care typically received a mix of VBH and in-person visits. Survey respondents who used VBH care had similar perceptions of the quality of their care and more-positive views of VBH than respondents who did not use VBH care. Few respondents had declined VBH care in favor of in-person care. Using these findings, the authors make recommendations on the role of VBH care in overall BH delivered by the military.

Key Findings

  • Direct care providers were less likely to deliver VBH than private-sector providers and relied heavily on audio VBH.
  • Soldiers who received VBH typically received a mix of VBH and in-person visits.
  • Receipt of VBH was associated with more-positive perceptions of VBH.
  • Soldiers who received VBH rated their military BH care similarly to those who received only in-person BH care.
  • Few soldiers declined VBH in favor of in-person care, but nearly one-third were not offered VBH.

Recommendations

  • Support the expanded delivery of VBH among military treatment facility providers by developing a VBH care strategic plan.
  • Assess barriers to VBH and ensure that military treatment facility providers are equipped and trained to deliver VBH.
  • Evaluate the utility of VBH in supporting continuity of BH care across military treatment facilities.

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Citation

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Hepner, Kimberly A., Joshua Breslau, Jessica L. Sousa, Carol P. Roth, Teague Ruder, Isabelle González, Cheryl K. Montemayor, and Beth Ann Griffin, Virtual Behavioral Health for Army Soldiers: Soldier Perspectives and Patterns of Treatment. Santa Monica, CA: RAND Corporation, 2023. https://www.rand.org/pubs/research_reports/RRA2241-1.html.
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This research was sponsored by the Office of the Surgeon General, U.S. Army and conducted within the Personnel, Training, and Health Program within the RAND Arroyo Center.

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