TOOLS FOR IMPLEMENTING RESPECT-MIL

Soldiers attending primary care for sick call, and who otherwise have a scheduled visit with a Primary Care Clinician, are routinely screened for depression (two questions) and PTSD (four questions). Those with positive screens complete appropriate diagnostic and severity instruments before seeing the Primary Care Clinician.

The PHQ-9 (for depression) and the PCL (for PTSD) are used as patient self-administered questionnaires to help confirm a diagnosis and determine symptom severity. Both contain suicide risk and functional impairment questions.

While the PHQ-9 and PCL may be utilized at any point during treatment, they should always be completed, scored and documented during the initial office visit with the Primary Care Clinician and then again at four week intervals by the Care Facilitator (during phone contacts) or Primary Care Clinician (during office visits) throughout the acute phase of treatment. In a brief time, the key elements of the Soldier’s status can be captured, allowing the Care Facilitator to communicate information or concerns to the Primary Care Clinician.

Care Facilitator treatment progress monitoring for both depression and PTSD should always begin at seven to ten days from diagnosis/referral. An earlier initial contact may be warranted with Soldiers who had some level of suicidal ideation indicated on the PHQ-9 or PCL. Click here for more information on Implementation.