Honoring their service: A participatory-based, collaborative approach to behavioral health systems for the Military and their families in North Carolina

Accessing comprehensive behavioral health care for service members, veterans, and their families is complicated by barriers including stigma, lack of behavioral health providers, and lack of coordination between the federal, state, and local systems of health care. In North Carolina, where more than one-third of the population is connected to the military, the Department of Defense, Department of Veterans Affairs, state, and community form a partnership named the Governor's Focus on Servicemembers, Veterans, and their Families. The Governor's Focus works to ensure that military families receive the best services available and has received national recognition from the Substance Abuse and Mental Health Services Administration. Building on this collaboration to address the behavioral health issues of our population, the North Carolina General Assembly requested that the North Carolina Institute of Medicine convene a diverse task force to examine the adequacy of mental health, developmental disabilities (including traumatic brain injury), and substance abuse services currently available the military, veterans, and their families. The Task Force and Steering Committee included representatives from active and reserve components of the military, veterans, family members, legislators, behavioral health professionals, federal and state agency representatives, and other community members. The task force process involved meeting to hear from experts to review behavioral health needs, demographics, and innovative programs in North Carolina. Consensus was reached on recommendations that were actionable and many are being implemented already. The priority recommendations included expanding counseling and treatment services; training for behavioral health, advocacy, and support professionals about the unique demographics and culture of the military; and improving transitions between the federal, state, and community systems. Because of the broad-based participation and history of collaboration, the state has already implemented changes to its system to better educate providers on the unique behavioral health needs of the military and to facilitate communication with the federal partners. Also, the North Carolina National Guard (NCNG) has opened its family assistance centers (FACs) to serve as one-stop resource centers equipped with referral information for local, state, and federal resources for any military-connected North Carolinians. The NCNG is now working to provide space for community, state and federal partners to provide services and group meetings within their FAC facilities. The success of this process in North Carolina may be translated into approaches to help address behavioral health service systems for the military and their families in other states.