Meet a Military Behavioral Health Case Manager

INTERVIEW BY ELAINE BRUNER, MSN, RN, CMGT-BC

Introduction: Case management for our armed services members includes different considerations than the civilian population. Stressors for military members and families include frequent moves, military control over salaries and education plus lack of childcare resources, and difficulties with spouse employment. I was honored to speak with Calley Smith, RN, at Fort Bragg, NC on her role as a behavioral health case manager.

Elaine (E): Calley, thanks for joining me in discussing the behavioral health (BH) case management role with active-duty service members (SMs). Who are the behavioral health case managers?

Calley (C): They are nurses and social workers in military treatment facilities and outpatient clinics. These professionals can be contractors or civil service employees. The BH role offers care coordination, across all levels of care, and resource management. My case management interface touches the entire formation, not just at Fort Bragg, so I am in contact with SMs outside of North Carolina.

E: When would SMs engage with you?

C: There are several ways I receive referrals:

• I’m embedded with a psychiatrist who refers complex BH patients, such as those with a dual diagnosis.
• SMs might self-refer when they have difficulty navigating the military healthcare system.
• SMs who are identified as high-risk or are frequent users of walk-in embedded BH services.
• Recent inpatient BH hospitalization.

E: Please describe how you support ADSM BH needs.

C: My interventions depend on the SM’s needs. In the Special Operations community, sleep issues and traumatic brain injuries are common in addition to the BH diagnosis. There continues to be a stigma surrounding BH care and its impact on a military career. Addressing the stigma by sharing that there is low risk to losing or changing their career is essential. Several senior military leaders have commented that they wish they had received BH care sooner because it may have saved their marriage.

One focus of my work is facilitating intensive outpatient programs (IOP) for those who need a higher level of care than outpatient BH care. Following SMs post-IOP is critical for after-care, medication management, and support.

I also educate on BH services, medications, and resources through phone calls and in-person visits. A plan of care is developed with our providers, social worker, and the SM/family. I’m passionate about identifying gaps in BH care and addressing needs.

E: CMSA published a position paper, “Communicating Your Value: The Case Manager’s Guide,” June 2024. I recognize your value; how would you share your value to:

C: SMs and families

• Emotional support.
• Effective transitions of care.
• Advocacy in BH services.

Colleagues

• Being a resource to other Commands and case managers.
• Problem-solving with the trans-professional team.
• Addressing gaps and barriers with BH services.

Organization/Command community

• Offering BH case management services across the healthcare continuum.
• Educating Command units on BH services.
• Collaborating with other Command case managers on complex cases.

E: Thanks for discussing your role and the significant impact on our AD population. Anything else you would like to share?

C: I want people to understand that working with the military is extremely gratifying and that the Special Forces community is unique within our armed services.

Calley Smith, RN, has served the United States Army Special Operations Command (USASOC) as the behavioral health (BH) nurse case manager at Fort Liberty for the past two years, managing complex behavioral health case for Special Operations Forces (SOF). With 21 years of diverse nursing experience, ranging from surgical services to consulting, she brings a broad base of knowledge to the field of healthcare.

Looking to the future, Calley aims to create innovative behavioral health resources to eliminate barriers and improve access to care for the SOF Soldiers.

Elaine Bruner, MSN, RN, CMGT-BC, is an experienced nurse, case manager, and educator. Her current position is as an active duty nurse case manager, U.S. Navy, where daily challenges keep her case management skills sharp plus reinforce her strong advocacy role. In 2008, Elaine was awarded the CMSA Award of Service Excellence for training and education with the Warrior Transition Unit at Brooke Army Medical Center. Elaine embraces her educator role, authoring manuscripts in CMSA Today, offering national and regional continuing education presentations, and coaching case managers to certification success. She is on the editorial board of CMSA Today. In October 2023, Elaine accepted the Co-Chair with the CMSA Military/Veteran/DoD Planning Committee. Her case management passions include military and veteran issues, food insecurity, and spirituality in healthcare practice.

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