DIVISION OF BEHAVIORAL AND SOCIAL HEALTH OUTCOMES PRACTICE (BSHOP)
MISSION: Use the public health process to provide the U.S. military with social and behavioral health information to inform prevention and risk mitigation strategies, public health interventions, and policies that maximize individual, unit, and community wellbeing.
VISION: Serve as the premier source for information on the epidemiology of social and behavioral health in the U.S. military.
HISTORY OF BSHOP: On a Saturday night in 2007, a male Army specialist was shot execution-style, twice in the head, at point blank range by a fellow Soldier while two other Soldiers looked on. Law enforcement officials would later learn that the three men involved in this incident were responsible for a rash of violent crimes committed on and around Fort Carson from 2005 to 2007.
What happened at Fort Carson was a watershed moment for the U.S. Army. Fort Carson, one of the largest installations in the country, was home to thousands of Iraq war veterans. With their return, it became apparent that the Army medical system was ill-equipped to deal with the influx of Soldiers with behavioral health (BH) and social health (SH) issues. Due to the lack of resources, a cookie-cutter approach was used for Soldiers presenting with a myriad of problems. Zoloft, an antidepressant, was often the prescribed drug of choice among Providers. The BH unit at Evans Army Community Hospital was operating with just two-thirds of its required staff, leaving a small number of psychiatrists and social workers to deal with a high demand for BH services. Soldiers waited hours to see Providers, Leaders minimized or failed to understand the seriousness of the problem, and stigma was rampant-- all of which prevented Soldiers from getting the care they needed.
On November, 3 2007, at the request of the installation Senior Mission Commander, a 24-member team was deployed to Fort Carson to conduct what became known as BSHOP's first Behavioral Health Epidemiologic Consultation (BH-EPICON). Using a model based on traditional outbreak investigations, the BH-EPICON team examined rates and trends in violent deaths involving Soldiers at Fort Carson, identified risk factors associated with those deaths, assessed the adequacy of BH resources, and recommended strategies to reduce the incidence of violent deaths.
Prior to 2008, multidisciplinary representatives from Army Public Health (then the Center for Health Promotion and Preventive Medicine), participated in the Headquarters, Department of the Army and Army Medicine's response to installation level requests for epidemiological assistance to address fatalities (e.g. suicide and murder-suicide). This formative work provided the basis for the evolution of BSHOP as a specialized public health capability. In July 2008, BSHOP was officially established at the U.S. Army Center for Health Promotion and Preventive Medicine (USACHPPM) – later renamed the U.S. Army Public Health Command, and now U.S. Army Public Center (USAPHC). Currently, BSHOP is nested within the Clinical Public Health and Epidemiology (CPHE) Directorate at USAPHC. BSHOP provides information and services to U.S. Army leadership service-wide, including the Vice Chief of Staff of the Army, the Army Surgeon General, Major Commands, installations, units (in theater and in garrison), and BH programs and military treatment facilities.
THE WORK OF BSHOP
Through the analysis of individual and population data (e.g., existing medical and administrative data, surveys, focus groups, and Soldier-level index case data), BSHOP strives to identify patterns, issues, and risk and protective factors associated with behavioral and social health to mitigate adverse outcomes.
BSHOP provides information and services to US Army leadership at various levels including the Office of the Surgeon General Behavioral Health Division, HQ DA G1 Army Resilience Directorate, AMEDD Center & School, Major Commands, installations, units (in theater and in garrison), behavioral health programs, and military treatment facilities.
BSHOP's staff is divided into two main sections:
Behavioral Health Monitoring Section (BHMS) - responsible for routine monitoring and reporting of BH trends among Soldiers in the Army
Field Investigations and Evaluations Section (FIES) - establish and provide epidemiological consultations using rigorous qualitative and quantitative methodologies and expertise