Psychologists in the Commissioned Corps of the Public Health Service have assisted the underserved in the United States since the 1940s—people held in federal prisons and immigration detention centers, members of American Indian tribes, the uninsured and impoverished.
Now the PHS is helping a new group: military service members and their families. Through an agreement with the Department of Defense, as many as 200 mental health professionals will be assigned to Army, Navy and Air Force hospitals in the United States.
The PHS wants to recruit at least 70 civilian psychologists—and military psychologists who had already decided to leave active duty—to join that effort. The Commissioned Corps of the Public Health Service is one of the nation's seven uniformed services, employing about 6,200 public health professionals across a wide array of federal agencies, such as the Indian Health Service, the Centers for Disease Control and Prevention and the Federal Bureau of Prisons.
Psychologists who join the corps complete a two-week officer basic training course in Leesburg, Va., enjoy benefits such as tax-free housing allowances and free health care, and, depending upon which agency they work for, are eligible for loan repayment.
Here's a look at four psychologists serving in the corps.
Capt. David J. McIntyre, PhD
Indian Health Service
Capt. David J. McIntyre, PhD, is a jack-of-all-trades within the PHS. He's treated prisoners at a maximum security federal prison in Pennsylvania and worked with people detained at an Arizona immigration facility.
But the job he's loved the most is working at the Indian Health Service, delivering behavioral health care to American Indians. In his first assignment, in 1995, he worked with members of the Shoshone and Paiute tribes in Nevada. Aside from a psychiatrist who'd visit once a month, McIntyre was the sole provider of mental health services—and faced a lot of skepticism at first.
"That first six months, a lot of people would say, 'You'll be here for a year or so and leave, and then it'll be some other guy coming in,'" he says.
To quell people's concerns, he made a concerted effort to listen and learn, rather than barging in as an expert with all the answers.
"I was getting much more than I was giving that first year," he says.
He also traveled long distances to small, outlying clinics, sometimes driving three hours to see one patient. Gradually, his efforts to build trust with local health workers paid off, and his office hours filled up. Now working at an Indian Health Service regional office in Phoenix, McIntyre volunteers as a recruiter, trying to interest psychologists in joining the Commissioned Corps.
He tells psychologists about his work on the reservations, but also about the chance to get called for specific deployments, such as the nearly two months McIntyre spent aboard the USNS Mercy, a Navy hospital ship, delivering care to people in Indonesia in early 2005.
"If you're in private practice, you're never going to get these opportunities," he says.
Cmdr. Hae-Kyung "Amy" Park, PhD
Health Resources and Services Administration
Cmdr. Hae-Kyung "Amy" Park, PhD, keeps a packed duffel bag in her closet at all times. As a "Ready Responder," with the Health Resources and Services Administration, she must be prepared to go to disaster sites within 24 hours of an order.
In 2005, Park traveled to help people displaced by Hurricane Katrina, working 14-hour days with other PHS officers to care for people at a treatment center in Alexandria, La. Many of the people had physical conditions and mental health problems, but didn't have a record of what medications they were taking or had run out of prescriptions. Working with physicians and pharmacists, Park helped develop treatment plans for them and helped sort through symptoms of physical illness and symptoms of mental health conditions.
When she's not deployed, Park works at a community health center serving low-income patients in Lewis County, Wash. Physicians refer patients to her for behavioral health consultations for conditions including diabetes, hypertension, obesity, depression and anxiety. She helps her patients take a more active role in managing their own medical conditions by focusing on health and wellness, and teaches them how to eat better and exercise. She also teaches coping strategies such as deep breathing and relaxation exercises to help people deal with stress.
Park also consults with the local Head Start program, observing children with behavior problems, then working with their teachers to improve their behavior. She also offers therapy to people who are caring for elderly and infirm parents, helping them deal with the emotionally and physically challenging task.
Park, a former Navy psychologist, joined the PHS to work with people who didn't have access to mental health care.
"The need is tremendous, and our psychology background, expertise and training really gives us a lot of skills to apply in these rural communities," she says.
Capt. Rafael Salas, PhD
Tripler Army Medical Center, Honolulu
These days, Capt. Rafael Salas, PhD, is wearing a different uniform, but he's back in a familiar role—helping soldiers deal with the stresses of combat and separation from family.
Salas served as an Army psychologist for nine years after completing the Army's internship program in 1991. He transitioned to the Commissioned Corps in 2000. In his role at Tripler Army Medical Center, Salas works with military families, particularly children who are distressed by their parents' long, repeated deployments and service members who are trying to ease back into family life.
Working with Cmdr. Angela Steele, PhD, another Commissioned Corps psychologist, Salas helped organize a 12-week outpatient therapy program for service members at risk for suicide and domestic violence due to post-traumatic stress disorder, anxiety or depression. The program treats service members with a combination of therapy, education and family counseling, Salas says.
"We're trying to alleviate their emotional suffering, and make them more functional," he says.
When he first left the military, Salas joined the Commissioned Corps to work in underserved communities. After a stint with the Indian Health Service, he worked at community health centers in Gonzales and Seguin, Texas, low-income, predominantly Hispanic communities. For five years, Salas assessed people facing criminal charges for drug and alcohol abuse, and delivered therapy to sexually and physically abused children.
Many of his clients lacked insurance and didn't have any other access to mental health services.
"I was the only Spanish-speaking psychologist in the county," he says.
Cmdr. Stacey Williams, PhD
Walter Reed Army Medical Center, Washington, D.C.
In 2003, former Army psychologist Maj. Stacey Williams, PhD, joined the Public Health Service to work at the pediatrics department of Walter Reed Army Medical Center. Trained as a pediatric neuropsychologist, Williams sees the children of active-duty service members, many of whom miss school because of stomachaches, vomiting and diarrhea. When physicians can't find anything physically wrong, they call her.
She's found that many of these children internalize the stress of moving to new bases and a parent's deployment to Iraq or Afghanistan, and learn not to complain.
Particularly with children in military families, you learn to suck it up and drive on, says Williams, serving at the rank of commander in the Commissioned Corps.
Now Williams is at the National Naval Medical Center in Bethesda, Md., where she offers family therapy and teaches relaxation techniques and biofeedback. Often, just getting the family to sit down and talk about their situation helps, she says.
Williams says the most rewarding part of her job is helping military families cope with the strain of service.
"They sacrifice so much for us to sit at home," she says.
Considering her work as a Commissioned Corps psychologist, Williams says one of the most enjoyable professional advantages is not haggling with health-insurance providers over how many times she can see a patient, or the best course of treatment.
"Here, the practitioner is the one who makes the clinical decisions," she says.