Walking into a mental health clinic and asking for help can be difficult. Walking out without the specialty mental health appointment you expected can leave you wondering what happens next.

At Bayne-Jones Army Community Hospital, Mental Health leaders want patients to understand that a recommendation to another resource isn’t a dismissal. It’s part of Targeted Care, the Defense Health Agency’s approach to connecting patients with the clinical or nonclinical resource best suited to their individual needs.

Lt. Col. Ivan Gonzalez, installation director of psychological health and chief of the BJACH Department of Mental Health, said Targeted Care recognizes that specialty mental health is one component of a broader continuum of care.

“The goal is to ensure that people seeking help are connected to the resource most appropriate for their needs as efficiently as possible,” Gonzalez said.

That may include specialty mental health, Primary Care-Mental Health, Military and Family Life Counselors, chaplains, Military OneSource, substance use services or other clinical and nonclinical resources.

“Targeted Care is about creating a coordinated system in which asking for help leads to a meaningful next step,” Gonzalez said. “It ensures we are providing the right care, at the right time, in the right setting.”

A referral isn’t being turned away

Targeted Care can be misunderstood, particularly when someone seeks help at the clinic and leaves without a specialty mental health appointment.

“Regardless of what recommendation was made, we never want someone who had the courage to seek help to leave feeling that their concerns were dismissed or that they were not heard,” Gonzalez said.

Being referred to another resource does not mean the patient doesn’t need or deserve help.

“It means, ‘Based on what you shared with us today, we believe this is the resource best positioned to help with what you are experiencing,’” Gonzalez said.

Sgt. 1st Class Elizabeth Waltz, noncommissioned officer in charge of Mental Health, puts it even more simply.

“It is not a dismissal. It is a tailored solution,” she said.

Concerns involving trauma, significant functional impairment, complex mental health conditions or safety may warrant specialty mental health services. Other concerns involving relationships, Family, work, finances, grief or adjustment to military life may be better addressed through another resource.

“Success is not simply putting an appointment on someone’s calendar,” Gonzalez said. “Success is connecting that person with the resource most likely to effectively address the problem that brought them through our doors.”

What happens when you walk in?

For many patients, Mental Health Technicians are among the first people they encounter at BJACH.

Waltz said technicians conduct the initial screening by gathering information about what brought the patient in, what they are experiencing and any immediate safety concerns.

“Most importantly, we listen,” Waltz said. “It is a conversation to understand their current stressors and to help ensure they are safe.”

Michael Breaux, a licensed clinical social worker at BJACH, said after the assessment, the technician reviews the information with a mental health provider, who considers the findings and relevant medical records to determine the best resource for the patient.

The decision is clinical — not simply a matter of which appointment happens to be available.

Gonzalez compared the process to other areas of health care.

“If someone comes to a medical clinic with a headache, we don’t automatically send that person to a neurosurgeon,” he said. “We assess the concern first and determine the appropriate level of care. Mental health operates according to the same principle.”

More than one door to support

One of those resources may be a chaplain.

Chaplain (Capt.) David Rutkin, a board-certified chaplain with the BJACH Department of Ministry and Pastoral Care, provides spiritual care addressing concerns such as meaning, purpose, hope, grief, moral injury and relationships, regardless of a patient’s faith background.

Clinical mental health and spiritual care serve different but complementary purposes. Mental Health providers may recommend chaplain support when spiritual, moral or existential concerns contribute to an individual’s distress, while Rutkin can recommend additional mental health care when a patient’s needs extend beyond his scope.

For someone referred through Targeted Care, Rutkin said there can be another benefit.

“I would like them to know — and be encouraged — that they have been connected with a professional who can sit with them today, rather than placing them on a long waitlist for a clinical appointment,” he said.

TRICARE beneficiaries may also have options outside BJACH.

Eddie Garcia, group practice manager for the BJACH Department of Mental Health, said while active-duty service members generally have different referral requirements, TRICARE Prime Family members and retirees can often receive outpatient mental health care from a TRICARE-authorized network provider without a referral. Some services may still require referrals or prior authorization.

Garcia encouraged beneficiaries to understand the requirements of their individual TRICARE plan and ensure civilian providers are TRICARE-authorized and, when applicable, in network before receiving care.

The door remains open

A Targeted Care recommendation isn’t permanent.

If symptoms worsen, circumstances change or the recommended resource doesn’t meet a patient’s needs, Gonzalez wants patients to return.

“We can reassess the situation and determine whether a different or higher level of care is appropriate,” he said. “The message I want our community to hear is: Please continue to reach out.”

For anyone struggling but unsure where to begin, Waltz said they don’t have to know which care option is right for them.

“Just walk into the clinic,” she said. “You do not need to figure out your own treatment plan. Let our team do the heavy lifting of figuring out where you need to go.”

“Reaching out is the only step you have to take alone.”

The BJACH Department of Mental Health is located on the sixth floor of the hospital at 1585 3rd St., Building 285. For more information, call 726-780-2566 or 726-780-2567.