The U.S. Army is proactively enhancing the health readiness of its soldiers by strategically transitioning the clinical assets of the Army Substance Abuse Program (ASAP) to the Army Medical Command (MEDCOM). This significant shift, slated for completion by May 31, 2017, underscores the Army’s commitment to leveraging health care data management to combat substance abuse and improve overall soldier well-being. By integrating Substance Use Disorder Clinical Care (SUDCC) within MEDCOM’s Behavioral Health System of Care (BHSOC), the Army aims to facilitate earlier detection, more effective intervention, and ultimately, better outcomes for soldiers and their families struggling with substance use disorders.
Soldiers participating in a training exercise, highlighting the Army's focus on readiness and well-being
While MEDCOM assumes responsibility for clinical care, Installation Management Command (IMCOM) will continue to oversee crucial ASAP functions such as drug testing, deterrence programs, alcohol and drug abuse prevention training, and curriculum development. This division of responsibilities allows for a more focused and efficient approach to tackling substance abuse within the Army. Currently, pilot programs at Fort Riley, Kansas; Fort Stewart, Georgia; Joint Base Lewis-McChord, Washington; and Schofield Barracks, Hawaii, are already demonstrating the benefits of integrated care models. These sites showcase improved access to care and enhanced coordination amongst clinical teams by merging substance use disorder treatment with broader behavioral health services.
The impetus for this transition is rooted in the stark reality of escalating substance abuse and substance use disorders within the Army since 2001. The prolonged stressors of ongoing conflicts have significantly contributed to this rise. Alarming statistics reveal that 30 percent of soldiers with behavioral health conditions also screen positive for substance use disorders, and a staggering 50 percent of those with suicidal thoughts exhibit excessive alcohol use. These figures prompted a comprehensive reassessment of ASAP’s structure, resources, and effectiveness in meeting the evolving health readiness demands of the force.
This critical review, initiated in March 2015 by then Secretary of the Army John McHugh, led to the decision to realign clinical care under MEDCOM. The objective was to rectify the impact of the 2010 realignment that placed the ASAP clinical program under IMCOM, and to optimize program results. Following extensive analysis, recommendations to integrate clinical care within MEDCOM and the BHSOC by October 1, 2016, were approved in October 2015. This integrated, multidisciplinary approach mirrors the BHSOC model, ensuring comprehensive care addressing illicit drug use, prescription medication misuse, and alcohol abuse for soldiers, family members, and Army civilians.
Integrating ASAP into behavioral health services promises enhanced management of co-occurring mental and physical health issues alongside substance use disorders. This holistic approach facilitates evidence-based early interventions, crucial for effective treatment. Furthermore, embedding behavioral health providers within unit footprints is expected to yield immediate benefits, including reduced missed duty time, elimination of redundant appointments, and improved treatment outcomes. Healthcare data management through the Army’s Behavioral Health Data Portal plays a pivotal role in this improved care system.
The Behavioral Health Data Portal is instrumental in maintaining clinical outcomes for every patient. This system furnishes real-time clinical outcome data and establishes a leadership framework to supervise clinical operations and results. Standardizing clinical programs within the BHSOC framework ensures consistent care delivery, robust leadership oversight of behavioral health clinical operations, and adherence to uniform ASAP protocols and regulations. Ultimately, this data-driven approach enhances the Army’s ability to monitor, evaluate, and refine its substance abuse programs, ensuring they are effective and responsive to the needs of soldiers.
Given that Army readiness remains the paramount priority, substance abuse is fundamentally incompatible with personnel and unit readiness, performance standards, and military discipline. The realignment of the ASAP SUDCC program into MEDCOM is a strategic move to provide soldiers and their families with holistic, integrated care that aligns with Defense policies, national standards, and best practices. This transition not only enhances command awareness and engagement through unit-aligned behavioral health care but also leverages health care data management to ensure accountability and continuous improvement in the Army’s fight against substance abuse, thereby bolstering the readiness and well-being of its most valuable asset – its soldiers.
