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There can be substantial variability in BHTs' responsibilities and skills, including time spent on clinical tasks

• BHTs engage in a wide variety of tasks, including screening and assessment, psychosocial interventions, treatment planning and monitoring, and outreach and resilience activities.
• Both BHTs and MHPs reported that BHTs perform screening and assessment activities most often, yet there was some variation in the amount of time BHTs spend on other clinical tasks, depending on their branch of service and current assignment.
• BHTs spent about one-third of their time in an average week on patient care–related responsibilities, although this varied significantly across service branches.

BHTs and MHPs differed in their perceptions of BHTs' proficiency and barriers to training and skill development

• BHTs and MHPs generally agreed that BHTs are most proficient at screening and assessment-related tasks, but BHTs rated their own proficiency higher than MHPs rated BHTs' proficiency.
• More than three-quarters of MHPs indicated that further education on how best to utilize BHTs' skills could improve the effectiveness of BHTs in the Military Health System.

BHTs and MHPs agreed that BHT training, supervision, and satisfaction could be improved

• BHTs and MHPs reported that BHTs spend insufficient time on training activities, especially continuing education.
• More than half of MHPs reported that BHTs receive inadequate supervision or that they were not sure whether BHTs receive adequate supervision.
• BHTs who indicated that they received inadequate supervision reported being less satisfied with their work and their supervisor.

Behavioral health technicians (BHTs), who are enlisted service members with the technical training to work alongside licensed mental health providers (MHPs), are an important part of the Military Health System (MHS) workforce. However, each service branch has different training requirements for BHTs, making it difficult to identify common qualifications across the BHT workforce and ensure that the MHS is making the best use of their skills. Building on prior RAND research that found inconsistencies in how BHTs were integrated across the force, researchers conducted what might be the largest survey to date of BHTs and MHPs. The results provide insights on BHTs' practice patterns, training and supervisory needs, and job satisfaction, as well as barriers to better integrating BHTs into clinical practice and steps that the MHS could take to optimize BHTs' contributions to the health and readiness of the force. Posing parallel sets of questions to BHTs and MHPs allowed comparisons of these groups' perspectives on these topics. The results revealed differences in views by service branch, time in practice, deployment history, and other characteristics. The researchers drew on these findings and recommendations to identify opportunities to optimize the BHT role.

• Chapter One

  Introduction

• Chapter Two

  Methods

• Chapter Three

  Demographic, Service, and Practice Characteristics

• Chapter Four

  BHT Responsibilities and Clinical Tasks

• Chapter Five

  Perceptions of BHT Proficiency

• Chapter Six

  Training and Supervision

• Chapter Seven

  Barriers to Effective BHT Practice

• Chapter Eight

  Satisfaction

• Chapter Nine

  Perceptions of Changes to BHT Practice

• Chapter Ten

  Conclusions and Recommendations

• Appendix A

  Survey Sampling and Weighting

• Appendix B

  Survey Development and Domains

• Appendix C

  BHT Survey

• Appendix D

  MHP Survey

• Appendix E

  Supplementary Analyses