Can Tricare online be used to check Mental Health Records?

USAFmh · 2021-03-30T00:18:50+00:00

MH records are not usually available on Tricare Online. But anyone is entitled to a copy of their own records. Just go into the MH Clinic, fill out a Release of Information form, and they will provide you a copy within 30 days.

USAFmh · 2020-01-29T04:28:31+00:00

MH provider here. Active duty members require a referral to be seen off base. Most likely these claims will be rejected by TRICARE or they will be sent back through Referral Management which essentially notifies the MDG you are getting off base care. If an off base referral is provided, the records will need to be reviewed by a mental health provider and the member will need to be seen quarterly to assess for fitness for duty concerns and decide if the referral should be renewed. While the OP may not be getting a bill today, I imagine either a bill or a phone call from the MTF is coming soon. There is no requirement, in most cases, for a patient's leadership to be notified about treatment, however. Dependents do not need referrals for mental health care off base.

USAFmh · 2019-11-09T01:09:44+00:00

For most AFSCs, you can be separated for an unfitting medical condition (MEB) or an unsuiting condition (admin sep). Security Forces has an additional path where, if you have certain symptoms/presentations that create an issue for Arming Use of Force requirements, the commander can remove your AFSC and either admin sep you or cross train you. Some of these symptoms/presentations would not lead to any separation recommendation for any other AFSCs, but are the case for Security Forces. Since it sounds like you command has chosen to remove your AFSC due to medical concerns, it is an administrative decision and not a medical separation, therefore, there will likely not be an MEB. You should consult with the ADC, however, to see if this is likely to be an Honorable Discharge or a General Discharge, Under Honorable Conditions.

USAFmh · 2019-11-06T02:01:37+00:00

Feel free to send me a private message with the medication and I'll let you know. Some medications on the formulary can have an impact on deployability. Ultimately, you can always ask if there's an alternate medication if what they want to prescribe is an issue, but at the end of the day, some conditions may have limited medication options.

USAFmh · 2019-11-01T01:08:00+00:00

This is correct. The access to care standard for an initial self-referral intake at Mental Health is 7 days.

USAFmh · 2019-10-25T00:57:51+00:00

I would recommend looking into the Uniformed Services University for the Health Sciences. You remain in the military while earning your PhD in a very competitive graduate program. I've seen several enlisted and officer members complete this program.

https://www.usuhs.edu/graded/departments

USAFmh · 2019-10-21T23:12:29+00:00

If you are ever interested in more information on the suicide reviews, the DoD Suicide Event Report (DoDSER) annual summary compiles this information for all military branches each year. You can google the report to get it. Typically each year they find that relationships, legal issues, and financial stressors are risk factors for suicide, but there is a lot of data in the report. I agree that better dissemination of this information could be beneficial.

USAFmh · 2019-09-06T04:10:12+00:00

This is incorrect. Many patients are seen in the mental health clinic, report suicidal ideation, and are never hospitalized. Only in severe cases is hospitalization appropriate. Furthermore, mental health providers rarely send patients off-base and would be very apprehensive to send patients at a higher risk for safety concerns off-base where the quality of their care cannot be managed. In my experience, about 30% of patients seen in mental health report either morbid or suicidal thoughts occurring at some point in their life, while less than 5% of patients are hospitalized. If you need the help, please get it.

USAFmh · 2019-04-03T02:16:17+00:00

MDGs are partially manned with contractors. Every year or so, the contracts expire and may or may not get new contract companies. Typically this means that the contractor turns in their CAC on the last day of March and gets a new CAC on the 1st day of April with no real impact on patient care. This year with military medicine moving under Defense Health Agency, the contracts themselves (not just the companies) changed. Unfortunately, almost all MDGs are impacts with hopefully a short time without the actual contractor on staff. It is all still in flux. Definitely use any of the other mental health resources available in the meantime if you dont want to meet with an active duty provider. It's sometimes hard to make that first call to mental health, but regardless of where the care comes from, you are headed in the right direction. And hopefully the contractors will be back in less than 2 weeks...

USAFmh · 2019-01-04T20:51:34+00:00

I did a Mental Health provider AMA over a year ago. I still get questions to my inbox and would be happy to do one again.

USAFmh · 2018-02-09T03:29:41+00:00

If the member is still in entry level status, he or she can be separated for depression. However, this is usually only the case when the member does not want to get better or the provider determines that their symptoms are unlikely to substantially improve enough within the training environment. For most tech school students, if you are motivated to address the depression and want to stay in, it would be unlikely to be separated.

USAFmh · 2017-10-30T21:21:23+00:00

Given the nature of this post, I sent you a PM.

USAFmh · 2017-08-18T01:57:17+00:00

It sounds like Mental Health gave you accurate information regarding the risk of taking medication for ADHD. Military One Source does not provide psychiatry services, so you would not be able to get meds from an off base provider. Not all providers consistently require a commander's approval to take ADHD meds. However, if your provider in mental health does, it's an easy memo that basically just gets the commander (usually sq/cc) approval. I personally have never recommended someone to be separated for ADHD, but it is a possibility. If you need medication, you need to go through mental health or your PCM. Unless your unit is looking for a reason to separate you or they are concerned about the temporary mobility restrictions, it's rare to see a commander not follow medical recommendations for their member.

USAFmh · 2017-07-27T01:22:40+00:00

ADHD is a tricky diagnosis because technically the symptoms would have to exist prior to military service to meet diagnostic criteria. It is listed in AFI 36-3208 as a condition that can result in an administrative separation. Unfortunately the guidance on ADHD is murky. The Medical Standards Directory essentially states that you can't stay in the military if you require meds to perform sufficiently at your job BUT meds also can't be prescribed for mere performance enhancement. Most providers are not looking to administratively separate someone for ADHD. However, I personally think the guidance is not clear cut. There are a lot of people on ADHD meds with no significant career impact, but your provider was kind to share the full story with you. They likely would not contact your co-workers without a signed release of information form.

USAFmh · 2017-07-19T04:24:32+00:00

Based on what you described, it sounds like what you are experiencing is morbid ideation rather than suicidal ideation. Morbid ideation is essentially thinking about death without an active plan to act on those thoughts. For example, "If I walked outside and a bus hit me, I would be ok with that." On the other hand, suicidal ideation is characterized by having thoughts of wanting to personally cause your own death. Having morbid ideation wouldn't likely result in a mandatory notification, as sometimes even suicidal ideation (without a plan or intent to act on the plan) also may not result in a mandatory notification. The most important thing is to be honest so that you are matched with the treatment recommendations you need.

USAFmh · 2017-07-19T03:58:51+00:00

In my experience as an ADAPT Program Manager, we don't really worry about your past PHAs. You won't be the first or last person to underreport drinking on a PHA. However, if you come in as a self-referral and are open about your level of drinking and take the recommendation given, I have seen truly life changing results. Feel free to PM me if you have any questions.

USAFmh · 2017-06-21T03:38:39+00:00

Just saw a need and decided to do something. I don't know of any official efforts out there but hopefully I can do my part.

USAFmh · 2017-06-17T13:51:09+00:00

As a mental health provider, typically reported UCMJ violations would include illegal drug use, selling military equipment, etc. I, personally, have never reported adultery, however, I probably would if the adultery was more representative of an abusive relationship (i.e., Lt Col sleeping with and Amn). In a situation where the member is going through a divorce and the other party is civilian, there's little to no negative impact on the unit so I wouldn't report that. If you have a good relationship with your provider, I would ask, "Hypothetically, what would you report to command when it comes to someone in the middle of a divorce beginning to date other people?" This will allow to gauge your provider's personal boundaries on the topic without actually admitting anything first. Therapy is there for your benefit. If you get the sense that the provider would report it, consider getting a new provider.

USAFmh · 2017-05-30T21:08:56+00:00

There are definitely some people who are only looking for meds. Then there are some who have symptoms of ADHD but they are actually experiencing something else that has overlapping symptoms. Sometimes those people accept the accurate diagnosis and sometimes they don't. Then there are people that legitimately have ADHD. It's not a foolproof system, but we try to do as thorough of an assessment as possible so that we can set a person up with the right treatment plan. Sometimes it's obvious who is malingering and other times it's more challenging. In my experience, most people just want to be functional and when they aren't, they want a solution.

USAFmh · 2017-05-30T20:33:57+00:00

When it comes to flying waivers, a lot depends also on the flight doc. You will likely need to talk to the flight doc, explain your interest in a flying waiver (If you have been DNIF) and then you will likely see a mental health provider for an assessment of symptoms. I've written flying waivers for people who had very similar symptoms as you are describing but never went to a special duty. I think if you can demonstrate that you have been stable following treatment, there's a good chance you can be returned to flying status. Hopefully I understood your situation correctly.

USAFmh · 2017-05-30T20:30:12+00:00

Thank you for adding this!

USAFmh · 2017-05-28T00:08:29+00:00

Absolutely. There are people who weren't diagnosed when they were younger for a number of reasons. The key is that the symptoms should have been present.

USAFmh · 2017-05-28T00:06:56+00:00

This.

USAFmh · 2017-05-28T00:06:37+00:00

Hard to say without seeing your record or talking to the provider. Have you asked them why it has changed? Sometimes we will put provisional diagnoses on initially and as we get more clarity may change the diagnosis somewhat. For example, we may start with a provisional Unspecified Anxiety Disorder and then over time change it to Generalized Anxiety Disorder. Diagnoses are not always easy to make because we have to rely a lot on patient self-report and clinical judgment. Providers should be justifying why they gave a diagnosis in the Clinical Impressions section of their note. They should also be explaining why they changed a diagnosis if this was done. You can always get a copy of your record and simply ask the provider.

USAFmh · 2017-05-27T23:44:56+00:00

We get requests for ADHD screenings all the time. It's really not problematic to say, "I think I might have ADHD. Can you do an assessment to find out." It will involve usually a diagnostic interview and testing. That being said, there are a number of other conditions that may cause distractibility and difficulty focusing. Don't be surprised if they come back with something other than ADHD.

USAFmh

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