Lessons learned from recent Behavioral Health Epidemiological Consultation (BH-EPICON) outbreak investigations

The US Army Institute for Public Health Behavioral and Social Health Outcomes Program (BSHOP) conducts behavioral health epidemiological consultation (BH-EPICON) outbreak investigations for the Army. The BH-EPICON process and study design is specifically tailored to address the issues of interest. In recent years, BSHOP has conducted field studies by request to investigate perceived or anticipated increases in suicidal, violent and high-risk behaviors in various Military populations. Through the analysis of existing data and the collection of new data on-site through interviews, focus groups and surveys, BSHOP has been able to provide military leadership recommendations for the identification and prevention of high-risk behavior. Specific findings differ according to the primary study objectives associated with the request and the events which precipitate the request, but several common themes have emerged, including several factors related to individual risk and systemic issues. Nearly all BH EPICONs observed an impact on increased negative BH outcomes (suicides and homicides) of individual risk factors related to deployment, family issues, evidence of previous behavioral health issues, and legal/financial issues. Likewise, systemic issues related to stigma, transition from deployment to garrison, problems with BH services and resources, lack of integrated care and issues surrounding leadership and unit climate have been observed as impacting behavioral risk taking. A summary of EPICON findings will be shared highlighting the use of both quantitative and qualitative methodological approaches. Specific processes used to collect and assess behavioral health information that may be of use to other behavioral health professionals will be shared.