Psychiatric medevacs during a 6-month aircraft carrier battle group deployment to the Persian Gulf: A Navy force health protection preliminary report

Military Medicine, Jan 2003 by Wood, Dennis Patrick

Without the availability of a clinical psychologist aboard USS Vinson, all nine of the hospitalized sailors may have been medevaced to Naval Hospitals in the United States for further evaluation, treatment, and disposition. By retaining these three sailors aboard USS Vinson for follow-on psychotherapy, the command was not required to order three additional medevacs flights at an estimated cost-savings of $12,200.00 ($4,400 x 3). (Garcia et al.25 have concluded that the average cost per medevac is $4,400.00. However, these medevac costs only include "the cost of fuel and maintenance, the ship's crew, the air crew, and a prorated cost of aircraft in-flight hazards." The $4,400.00 figure does not include the cost of launching and recovering an aircraft, the landing risks and charges of the medevac flight at the embarked airport and the cost to fly the corpsman escort and sailor/patient on a commercial or military flight from the embarked airport back to the United States, the corpsman escort's temporary active duty costs and the cost of flying the corpsman escort back to his Command). Furthermore, the USS Vinson gained 250 man-days due to the retention of the three sailors.

Conclusions and Recommendations

Having a clinical psychologist and a psychiatric technician as full-time members of the aircraft carrier's medical department is a new and vibrant component of the Navy's FHP Program. During USS Carl Vinson battle group's 1998/1999 WESTPAC deployment, these two clinicians provided a robust mental health presence that resulted in measurable therapeutic outcomes for the embarked officers and sailors. Furthermore, the clinical psychologist and psychiatric technician adroitly and professionally completed complicated evaluations of sailors with lifethreatening psychiatric difficulties. The clinical psychologist measurably contributed to an increase in the quality of the sailors' lives through expert supervision of the CAAC and through the strength of the command's suicide prevention and stress/anger management programs.

Given the positive evaluative, treatment, and retention outcomes resulting from the therapeutic interventions of the clinical psychologists aboard USS Vinson and Kitty Hawk, the cost benefits of the Clinical Psychology At-Sea Program are highlighted. The Navy's Bureau of Medicine and Surgery established $94,000.00 as the annual program rate for assigning a Navy clinical psychologist to an aircraft carrier and $43,000.00 as the annual program rate for assigning a hospital corpsman with psychiatric technician training to an aircraft carrier.26 To fully appreciate the positive impact and cost-benefits of the Clinical Psychology At-Sea Program, it is going to be important for the Navy's Bureau of Medicine and Surgery to establish applicable monitoring and surveillance systems to objectively measure the evaluative, intervention, treatment, and retention outcomes attributable to the clinical psychologists assigned to air craft carriers. For instance, although a discussion concerning the numerical difference between the inpatient psychiatric admissions on USS Vinson vs. Kitty Hawk is beyond the scope of this article, such a discussion would not be beyond the scope of the Navy's FHP monitoring and surveillance program.