Needs Assessment and Goal Setting

Introduction

Many service members suffer from mental health issues, but it is not prevalent until

symptoms are extreme such as having suicidal ideation with plan and intent. It is important for

behavioral health educators to educate and focus on stress and anxiety management, general

behavioral health education, and prevention/intervention for military personnel. The Army

utilizes behavioral health services to support soldiers. But due to lack of behavioral health

education for military personnel, many service members are required intensive behavioral health

care and service when things could have not escalated. As a health educator, I would like to

emphasize and address the prevention portion of behavioral health service in addition to

addressing effective intervention. Furthermore, as a health educator, it is important to outreach

and use stress and anxiety management as a preventive measure.

Context

The military has been focusing on treating many service members who went through

wars in Iraq and Afghanistan, regarding their mental health issues. Many people think that

mental health issues in the military are combat related; however, we see a trend of increasing

mental health issues among general military service members who have not experienced combat

(Inoue et al, 2023). Not only many active service members deal with mental health issues, but

veterans suicide rates have been increasing every year by 30% between 1999 and 2016 (Inoue et

al, 2023). The Department of Defense has implemented programs for resilience and prevention

that focuses on mental health; however, many resilience, prevention, and intervention programs

are not theoretical frameworks and not consistent based on evidence (Denning et al, 2014).

Furthermore, the Department of Defense utilizes civilian prevention/intervention programs that

have not been tested for the military population (Denning et al, 2014). There is a lack of outreach

and education and poor utilization of military behavioral health specialists/mental health

technicians, and mental health providers. In addition, there is a lack of follow up assessment to

see if the efforts of prevention and early intervention have worked (Denning et al, 2014).

Moreover, many leaders lack behavioral health education and utilization of resources, which

furthermore become a roadblock for service members who need management of mental health

issues, prevention and intervention services.

Assessment of Current Intervention

The military has prevention and intervention programs to support service members who

may be going through mental health issues. For example, the Army has a program called the

Master Resilience Training, where it focuses on self-awareness, self-regulation, optimism,

mental agility, strengths of character and connection, and teaches soldiers how to be resilient

during hardships (ARD: Master Resilience Training, 2020). There are also free workshops on the

base, which topics vary from relationship to finance, that can potentially help service members

with their ongoing stressors. Although there are training or programs like the Master Resilience

Training, there is a lack of consistency in training and effectiveness, and it feels like more

“check-the-box” training. Resilience is an important part of preventive efforts, which behavioral

health educators should really utilize effective resiliency training as a part of preventive measure

strategy.

One of the most effective intervention programs that the Army has regarding mental

health is Traumatic Event Management (TEM). Traumatic Event Management is an intervention

aimed to support service members who experience potentially traumatizing incidents whether it

is combat related or non-combat related, which is a component of Combat Operational Stress

Control (COSC); TEM focuses on unit need assessments, command consultation and education,

stabilization and restoration procedures, counseling, psychological first aid, and psychological

debriefing (Jones et al, 2013). Ideally, TEM was used for combat-related situations, but TEM can

be used for any traumatic events, such as suicide in the unit, natural disaster, etc. Not a lot of

command teams know how to utilize TEM, which is a good resource to support service

members’ mental health.

Applying Theory

The theory that would be applied for educating and focusing on stress and anxiety

management, general behavioral health education, and prevention/intervention for military

personnel as a health educator is the Social Network, Social Support, and Social Capital Theory.

Social networks are social ties that are potentially supportive, social support is physical and

emotional mental support from family, friends, co-workers, etc., and social capital is resources

that individuals and groups have within their network (Fertman, 2016).

Many behavioral health utilizes group therapy as a part of the treatment. Group therapy

sessions normally last 5 to 10 weeks. During the group session, many service members connect

with each other due to having similar backgrounds, which being in the military. In a sense, they

became a support for one another and learn from each other’s experiences as well as being

empathetic to each other, knowing that they are not alone. Applying Social Network, Social

Support, and Social Capital theory, these bonds that service members formed during group

sessions can lead to improvements in psychological health (Fertman, 2016). Most people are in

group therapy so they can better themselves such as learning coping skills, changing their

thought process, etc. With this mentality, service members can positively influence each other on

their mental health.

Health Education Plan and Intervention

The overarching health education plan is to educate military personnel on mental health

in general and management of mental health issues. Another plan is to educate leaders regarding

mental health and how they can support their troops when it comes to mental health issues. Many

leaders do not know how behavioral health or mental health resources should be utilized. Not all

service members need behavioral health services, but rather, they need some sort of healthy

psychological guidance that health educators can provide such as coping skills, stress

management, etc. Furthermore, as a behavioral health educator, outreach is a great tool for

prevention and intervention. Sometimes service members need to feel connected to reach out for

help, because many service members are still hesitant to get mental health support due to stigma,

although mental health stigma has improved over the years in the military. That is why actively

going to the units to educate service members in a group regarding mental health resources or to

give them brief about stress management tips, etc. In addition, being in a group setting, you can

actively make people engage in mental health topics, which can allow others to better understand

and influence each other positively.

SMART Goals

● Outreach Program: go to the unit(s) every two weeks and educate service members on

specific mental health topics (i.e. stress management) in a group setting, approximately

90 minutes; encourage maximum participation to positively influence each other and

allow service members to empathize and understand each other better, which would bring

unit cohesion and great teamwork; measurable by unit need assessments if these

outreaches were effective or not; after educational group session is complete, stay behind

and talk to service members who need additional behavioral health resources
 ● Command Education: educate leadership regarding behavioral health resources and

process; every month with different topics how they can support service members when it

comes to behavioral health issues

Conclusion

In this need assessment, I have discussed what behavioral health prevention and

intervention programs are in the military, particularly Army, and if these programs are effective,

and how it can be improved. Instead of waiting until service members need therapy focused

treatment due to mental breakdown, it is important for behavioral health educators to intervene

before these situations escalate to the point where service members need intensive therapy,

especially because behavioral health providers are scarce in the military and service members

may have to wait 3 months to see a provider. More behavioral health outreach programs should

be implemented for prevention and intervention purposes.

 References

ARD: Master Resilience Training. (2020). Army.mil.

https://www.armyresilience.army.mil/ard/R2/Master-Resilience-Training.html

Denning, L. A., Meisnere, M., Warner, K. E., Families, C. on the A. of R. and P. P. for M. and B.

H. in S. M. and T., Populations, B. on the H. of S., & Medicine, I. of. (2014, February

11). SUMMARY. Www.ncbi.nlm.nih.gov; National Academies Press (US).

https://www.ncbi.nlm.nih.gov/books/NBK222160/

Fertman, C. I. (2016). Health promotion programs : From theory to practice. John Wiley &

Sons, Incorporated.

Inoue, C., Shawler, E., Jordan, C. H., & Jackson, C. A. (2023, August 17). Veteran and Military

Mental Health Issues. PubMed; StatPearls Publishing.

https://www.ncbi.nlm.nih.gov/books/NBK572092/

Jones, D. E., Hammond, P., & Platoni, K. (2013). Traumatic Event Management in Afghanistan:

A Field Report on Combat Applications in Regional Command-South. Military Medicine,

178(1), 4–10. https://doi.org/10.7205/milmed-d-12-00070

 Health Education Plan Projects

● Outreach Program: go to the unit(s) every two weeks and educate service members on

specific mental health topics (i.e. stress management) in a group setting, approximately

90 minutes; encourage maximum participation to positively influence each other and

allow service members to empathize and understand each other better, which would bring

unit cohesion and great teamwork; measurable by unit need assessments if these

outreaches were effective or not; after educational group session is complete, stay behind

and talk to service members who need additional behavioral health resources

○ Number of Participants Potentially Recruit: depending on the unit size; 10-50

soldiers

○ Delivery setting: in-person

■ Large group (~30+): in a multi-purpose conference room or auditorium

■ Small group (~15): regular conference room or meeting room

○ Timeline

■ Contact the command team to organize for time, date, and place, and

number of soldiers who are attending. The room must have technology

set-up for

■ Send a pre-survey to the command team to disperse to the soldiers so the

educator can have a general understanding of the soldiers’ needs.

■ Receive back pre-surveys/unit need assessments and analyze the soldiers’

needs. Pick a topic that would help soldiers’ mental well-being.

■ Attend the organized education session to present the mental health topic

and educate soldiers on topics that most soldiers choose on pre-survey.

(60-90 minutes)

● During the education intervention, allow soldiers to interact and

discuss with each other in a small group (2-3 people per group) for

5-10 minutes and have 1-2 soldiers to present briefly (1-2 minutes)

about things they have discussed.

● At the end of the education intervention presentation, give soldiers

other resources that can potentially help them further.

● Close with Q & A sessions (10-15 minutes).

■ Stay behind 15-20 minutes for individual questions that may be sensitive

topics.

■ Meet with the command team for after action reviews (what was good and

what can be improved).

■ A week after the first education/intervention session, send the command

team post-needs assessment for soldiers to identify if

education/intervention was effective, and what has worked for them, and

what can be improved.

■ Analyze the post-needs assessment. Plan according to the post-unit

assessment for the next education intervention session or choose another

topic that you can go over with the soldiers.

 ■ Follow up and discuss with the command team regarding post-needs

assessments and educate them what they can do to support soldiers.

Schedule for next time, date, and place.

■ Repeat 3-5 times depending on the unit’s intervention needs.

○ Resources need

Supplies Purpose Cost

Paper Surveys/Needs $0; coming out of

Assessment command budget

Mental health To provide further $0; other clinics and

pamphlets resources organization have
pamphlets

○ Educational materials (depending on which mental health topic educator is

presenting)

■ Worksheet/pamphlets - summarization of the topic that was presented and

tips they can utilize; allowing soldiers to take charge of their mental

health; worksheet for soldiers to outline their plans to apply they have

learned during education intervention

● Stress management worksheet/pamphlet - for soldiers who need

stress management tips

● Anger management worksheet/pamphlet - for soldiers who need

anger management tips

● Goal setting/time management worksheet/pamphlets - for soldiers

who need goal setting time management tips

● More worksheet and pamphlets depending on the topic of

education intervention

● Sleep hygiene information worksheet (therapistaid.com)

●
 ■ MFLC - Military and Family Life Counseling brochure - for soldiers who

need further assistance with mental health, but do not want to be on record

■ Behavioral Health/Mental Health clinics on post - for soldiers who need

more intensive intervention

○ For presentation purposes, I chose sleep hygienic as a mental health topic for

education intervention.
 References

Military and Family Life Counseling. (n.d.). Military OneSource.

https://www.militaryonesource.mil/non-medical-counseling/military-and-family-li

fe-counseling/

Sleep Hygiene Handout (Worksheet). (n.d.). Therapist Aid.

https://www.therapistaid.com/therapy-worksheet/sleep-hygiene-handout

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 Pre-Survey for Sleep Hygiene Class

Describe your sleep in your own words: ___________________________________

How many hours do you typically sleep?

Less than 4 hrs / 4 - 6 hrs / 7 - 8 hrs / 9 hrs and more

How satisfied are you with your sleep?

Very satisfied / satisfied / neutral / dissatisfied / very dissatisfied

Please circle that applies to you.

Frequent awakening (more than once every night) / difficulty falling asleep / difficulty
staying asleep / frequent dreaming / nightmares (more than once a week)

How would you rate your overall sleep quality during the last month? (PSQI)
Very good / fairly good / neutral / fairly bad / very bad

To what extent does your sleep problem interfere with your daily life? (ISI)
Very much interfering / much / somewhat / barely / not at all interfering

How much is it noticeable to others that your sleeping problem is impairing the
quality of your life? (ISI)
Very much noticeable / much / somewhat / barely / not at all noticeable

How worried are you about your current sleep problem? (ISI)
Very much / much / somewhat / barely / not at all

What do you want to learn or achieve from sleep hygiene class?

______________________________________________________________________
 Post-Survey for Sleep Hygiene Class

From what you have learned in class, what can you apply to improve your sleep?
_____________________________________________________________

Was this class helpful?

Very much / much / somewhat / barely / not at all

How was this class helpful to you? _______________________________________

How can this class be improved for next attendees? _________________________

How would you rate this class? (10 being best, 1 being worst)
10 / 9 / 8 / 7 / 6 / 5 / 4 / 3 / 2 / 1

Would you recommend this class to your peers?

Yes / No

Is there anything that is not in your control that disturbs your sleep? (e.g. staff
duty, command team, etc.) _____________________________________________
 References

Shahid, A., Wilkinson, K., Marcu, S., & Shapiro, C. M. (2011a). Insomnia Severity Index

(ISI). STOP, THAT and One Hundred Other Sleep Scales, 191–193.

https://doi.org/10.1007/978-1-4419-9893-4_43

Shahid, A., Wilkinson, K., Marcu, S., & Shapiro, C. M. (2011b). Pittsburgh sleep quality

index (PSQI). STOP, THAT and One Hundred Other Sleep Scales, 67(67),

279–283. https://doi.org/10.1007/978-1-4419-9893-4_67
Intervention Powerpoint Link:

https://docs.google.com/presentation/d/1bq-iwGSMKg1idHMVJZMWwcof9OSpsemkbeJ

krsVaGlc/edit?usp=sharing

Presentation Link: https://youtu.be/8p3jwhXJ9yQ

Portfolio website link: https://starfield817.weebly.com/

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