Committee on the Assessment of Resiliency and Prevention Programs for Mental and Behavioral Health in Service Members and Their Families's Books

Preventing Psychological Disorders in Service Members and Their Families

An Assessment of Programs

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Assessment of Resiliency and Prevention Programs for Mental and Behavioral Health in Service Members and Their Families

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Preventing Psychological Disorders in Service Members and Their Families

An Assessment of Programs

Being deployed to a war zone can result in numerous adverse psychological health conditions. It is well documented in the literature that there are high rates of psychological disorders among military personnel serving in Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom in Iraq as well as among the service members' families. For service members' families, the degree of hardship and negative consequences rises with the amount of the service members' exposure to traumatic or life-altering experiences. Adult and child members of the families of service members who experience wartime deployments have been found to be at increased risk for symptoms of psychological disorders and to be more likely to use mental health services. In an effort to provide early recognition and early intervention that meet the psychological health needs of service members and their families, DOD currently screens for many of these conditions at numerous points during the military life cycle, and it is implementing structural interventions that support the improved integration of military line personnel, non-medical caregivers, and clinicians, such as RESPECT-Mil (Re-engineering Systems of Primary Care Treatment in the Military), embedded mental health providers, and the Patient-Centered Medical Home. Preventing Psychological Disorders in Service Members and Their Families evaluates risk and protective factors in military and family populations and suggests that prevention strategies are needed at multiple levels - individual, interpersonal, institutional, community, and societal - in order to address the influence that these factors have on psychological health. This report reviews and critiques reintegration programs and prevention strategies for PTSD, depression, recovery support, and prevention of substance abuse, suicide, and interpersonal violence.

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304

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National Academies Press

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ISBN 10

0309297184

ISBN 13

9780309297189

Preventing Psychological Disorders in Service Members and Their Families

An Assessment of Programs

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Preventing Psychological Disorders in Service Members and Their Families

An Assessment of Programs

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304

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National Academies Press

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0309297184

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9780309297189

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations

Initial Assessment

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Assessment of Ongoing Efforts in the Treatment of Posttraumatic Stress Disorder

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Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations

Initial Assessment

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Assessment of Ongoing Efforts in the Treatment of Posttraumatic Stress Disorder

Prior to the military conflicts in Iraq and Afghanistan, wars and conflicts have been characterized by such injuries as infectious diseases and catastrophic gunshot wounds. However, the signature injuries sustained by United States military personnel in these most recent conflicts are blast wounds and the psychiatric consequences to combat, particularly posttraumatic stress disorder (PTSD), which affects an estimated 13 to 20 percent of U.S. service members who have fought in Iraq or Afghanistan since 2001. PTSD is triggered by a specific traumatic event - including combat - which leads to symptoms such as persistent re-experiencing of the event; emotional numbing or avoidance of thoughts, feelings, conversations, or places associated with the trauma; and hyperarousal, such as exaggerated startle responses or difficulty concentrating. As the U.S. reduces its military involvement in the Middle East, the Departments of Defense (DoD) and Veterans Affairs (VA) anticipate that increasing numbers of returning veterans will need PTSD services. As a result, Congress asked the DoD, in consultation with the VA, to sponsor an IOM study to assess both departments' PTSD treatment programs and services. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment is the first of two mandated reports examines some of the available programs to prevent, diagnose, treat, and rehabilitate those who have PTSD and encourages further research that can help to improve PTSD care.

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414

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National Academies Press

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ISBN 10

0309254213

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9780309254212

Strengthening the Military Family Readiness System for a Changing American Society

By: National Academies of Sciences, Engineering, and Medicine,Division of Behavioral and Social Sciences and Education,Board on Children, Youth, and Families,Committee on the Well-Being of Military Families

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Strengthening the Military Family Readiness System for a Changing American Society

The U.S. military has been continuously engaged in foreign conflicts for over two decades. The strains that these deployments, the associated increases in operational tempo, and the general challenges of military life affect not only service members but also the people who depend on them and who support them as they support the nation â€" their families. Family members provide support to service members while they serve or when they have difficulties; family problems can interfere with the ability of service members to deploy or remain in theater; and family members are central influences on whether members continue to serve. In addition, rising family diversity and complexity will likely increase the difficulty of creating military policies, programs and practices that adequately support families in the performance of military duties. Strengthening the Military Family Readiness System for a Changing American Society examines the challenges and opportunities facing military families and what is known about effective strategies for supporting and protecting military children and families, as well as lessons to be learned from these experiences. This report offers recommendations regarding what is needed to strengthen the support system for military families.

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385

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National Academies Press

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ISBN 10

0309489563

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9780309489560

Strengthening the Military Family Readiness System for a Changing American Society

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Strengthening the Military Family Readiness System for a Changing American Society

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385

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ISBN 10

0309489539

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9780309489539

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations

Final Assessment

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Assessment of Ongoing Efforts in the Treatment of Posttraumatic Stress Disorder

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Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations

Final Assessment

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Assessment of Ongoing Efforts in the Treatment of Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) is one of the signature injuries of the U.S. conflicts in Afghanistan and Iraq, but it affects veterans of all eras. It is estimated that 7-20% of service members and veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom may have the disorder. PTSD is characterized by a combination of mental health symptoms - re-experiencing of a traumatic event, avoidance of trauma-associated stimuli, adverse alterations in thoughts and mood, and hyperarousal - that last at least 1 month and impair functioning. PTSD can be lifelong and pervade all aspects of a service member's or veteran's life, including mental and physical health, family and social relationships, and employment. It is often concurrent with other health problems, such as depression, traumatic brain injury, chronic pain, substance abuse disorder, and intimate partner violence. The Department of Defense (DoD) and the Department of Veterans Affairs (VA) provide a spectrum of programs and services to screen for, diagnose, treat for, and rehabilitate service members and veterans who have or are at risk for PTSD. The 2010 National Defense Authorization Act asked the Institute of Medicine to assess those PTSD programs and services in two phases. The Phase 1 study, Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment, focused on data gathering. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations Final Assessment is the report of the second phase of the study. This report analyzes the data received in Phase 1 specifically to determine the rates of success for each program or method. Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations Final Assessment considers what a successful PTSD management system is and whether and how such a system is being implemented by DoD and VA. This includes an assessment of what care is given and to whom, how effectiveness is measured, what types of mental health care providers are available, what influences whether a service member or veteran seeks care, and what are the costs associated with that care. This report focuses on the opportunities and challenges that DoD and VA face in developing, implementing, and evaluating services and programs in the context of achieving a high-performing system to care for service members and veterans who have PTSD. The report also identifies where gaps or new emphases might be addressed to improve prevention of, screening for, diagnosis of, and treatment and rehabilitation for the disorder. The findings and recommendations of Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment will encourage DoD and VA to increase their efforts in moving toward a high-performing, comprehensive, integrated PTSD management strategy that addresses the needs of current and future service members, veterans, and their families.

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262

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National Academies Press

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ISBN 10

0309301769

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9780309301763

Returning Home from Iraq and Afghanistan

Assessment of Readjustment Needs of Veterans, Service Members, and Their Families

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Assessment of Readjustment Needs of Military Personnel, Veterans, and Their Families

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Returning Home from Iraq and Afghanistan

Assessment of Readjustment Needs of Veterans, Service Members, and Their Families

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Assessment of Readjustment Needs of Military Personnel, Veterans, and Their Families

As of December 2012, Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) in Iraq have resulted in the deployment of about 2.2 million troops; there have been 2,222 US fatalities in OEF and Operation New Dawn (OND)1 and 4,422 in OIF. The numbers of wounded US troops exceed 16,000 in Afghanistan and 32,000 in Iraq. In addition to deaths and morbidity, the operations have unforeseen consequences that are yet to be fully understood. In contrast with previous conflicts, the all-volunteer military has experienced numerous deployments of individual service members; has seen increased deployments of women, parents of young children, and reserve and National Guard troops; and in some cases has been subject to longer deployments and shorter times at home between deployments. Numerous reports in the popular press have made the public aware of issues that have pointed to the difficulty of military personnel in readjusting after returning from Iraq and Afghanistan. Many of those who have served in OEF and OIF readjust with few difficulties, but others have problems in readjusting to home, reconnecting with family members, finding employment, and returning to school. In response to the return of large numbers of veterans from Iraq and Afghanistan with physical-health and mental-health problems and to the growing readjustment needs of active duty service members, veterans, and their family members, Congress included Section 1661 of the National Defense Authorization Act for fiscal year 2008. That section required the secretary of defense, in consultation with the secretary of veterans affairs, to enter into an agreement with the National Academies for a study of the physical-health, mental-health, and other readjustment needs of members and former members of the armed forces who were deployed in OIF or OEF, their families, and their communities as a result of such deployment. The study consisted of two phases. The Phase 1 task was to conduct a preliminary assessment. The Phase 2 task was to provide a comprehensive assessment of the physical, psychologic, social, and economic effects of deployment on and identification of gaps in care for members and former members, their families, and their communities. The Phase 1 report was completed in March 2010 and delivered to the Department of Defense (DOD), the Department of Veterans Affairs (VA), and the relevant committees of the House of Representatives and the Senate. The secretaries of DOD and VA responded to the Phase 1 report in September 2010. Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families fulfills the requirement for Phase 2.

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795

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National Academies Press

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ISBN 10

0309264278

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9780309264273

Substance Use Disorders in the U.S. Armed Forces

By: Institute of Medicine,Board on the Health of Select Populations,Committee on Prevention, Diagnosis, Treatment and Management of Substance Use Disorders in the U.S. Armed Forces

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Substance Use Disorders in the U.S. Armed Forces

By: Institute of Medicine,Board on the Health of Select Populations,Committee on Prevention, Diagnosis, Treatment and Management of Substance Use Disorders in the U.S. Armed Forces

Problems stemming from the misuse and abuse of alcohol and other drugs are by no means a new phenomenon, although the face of the issues has changed in recent years. National trends indicate substantial increases in the abuse of prescription medications. These increases are particularly prominent within the military, a population that also continues to experience long-standing issues with alcohol abuse. The problem of substance abuse within the military has come under new scrutiny in the context of the two concurrent wars in which the United States has been engaged during the past decade-in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom and Operation New Dawn). Increasing rates of alcohol and other drug misuse adversely affect military readiness, family readiness, and safety, thereby posing a significant public health problem for the Department of Defense (DoD). To better understand this problem, DoD requested that the Institute of Medicine (IOM) assess the adequacy of current protocols in place across DoD and the different branches of the military pertaining to the prevention, screening, diagnosis, and treatment of substance use disorders (SUDs). Substance Use Disorders in the U.S. Armed Forces reviews the IOM's task of assessing access to SUD care for service members, members of the National Guard and Reserves, and military dependents, as well as the education and credentialing of SUD care providers, and offers specific recommendations to DoD on where and how improvements in these areas could be made.

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350

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National Academies Press

Published Date

ISBN 10

0309260558

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9780309260558

Evaluation of the Department of Veterans Affairs Mental Health Services

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,Committee to Evaluate the Department of Veterans Affairs Mental Health Services

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Evaluation of the Department of Veterans Affairs Mental Health Services

Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.

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467

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National Academies Press

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ISBN 10

0309466601

ISBN 13

9780309466608

Strengthening the Military Family Readiness System for a Changing American Society

By: Engineering National Academies of Sciences (and Medicine)

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Strengthening the Military Family Readiness System for a Changing American Society

By: Engineering National Academies of Sciences (and Medicine)

The U.S. military has been continuously engaged in foreign conflicts for over two decades. The strains that these deployments, the associated increases in operational tempo, and the general challenges of military life affect not only service members but also the people who depend on them and who support them as they support the nation and their families. Family members provide support to service members while they serve or when they have difficulties; family problems can interfere with the ability of service members to deploy or remain in theater; and family members are central influences on whether members continue to serve. In addition, rising family diversity and complexity will likely increase the difficulty of creating military policies, programs and practices that adequately support families in the performance of military duties. Strengthening the Military Family Readiness System for a Changing American Society examines the challenges and opportunities facing military families and what is known about effective strategies for supporting and protecting military children and families, as well as lessons to be learned from these experiences. This report offers recommendations regarding what is needed to strengthen the support system for military families.

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385

Published Date

ISBN 10

0309489547

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9780309489546

Provision of Mental Health Counseling Services Under TRICARE

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Qualifications of Professionals Providing Mental Health Counseling Services Under TRICARE

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Provision of Mental Health Counseling Services Under TRICARE

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Qualifications of Professionals Providing Mental Health Counseling Services Under TRICARE

In this book, the IOM makes recommendations for permitting independent practice for mental health counselors treating patients within TRICARE-the DOD's health care benefits program. This would change current policy, which requires all counselors to practice under a physician's supervision without regard to their education, training, licensure or experience.

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351

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National Academies Press

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ISBN 10

0309157196

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9780309157193

Preparing for the Psychological Consequences of Terrorism

A Public Health Strategy

By: Institute of Medicine,Board on Neuroscience and Behavioral Health,Committee on Responding to the Psychological Consequences of Terrorism

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Preparing for the Psychological Consequences of Terrorism

A Public Health Strategy

By: Institute of Medicine,Board on Neuroscience and Behavioral Health,Committee on Responding to the Psychological Consequences of Terrorism

The Oklahoma City bombing, intentional crashing of airliners on September 11, 2001, and anthrax attacks in the fall of 2001 have made Americans acutely aware of the impacts of terrorism. These events and continued threats of terrorism have raised questions about the impact on the psychological health of the nation and how well the public health infrastructure is able to meet the psychological needs that will likely result. Preparing for the Psychological Consequences of Terrorism highlights some of the critical issues in responding to the psychological needs that result from terrorism and provides possible options for intervention. The committee offers an example for a public health strategy that may serve as a base from which plans to prevent and respond to the psychological consequences of a variety of terrorism events can be formulated. The report includes recommendations for the training and education of service providers, ensuring appropriate guidelines for the protection of service providers, and developing public health surveillance for preevent, event, and postevent factors related to psychological consequences.

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184

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National Academies Press

Published Date

ISBN 10

0309167922

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9780309167925

Book's by Committee on the Assessment of Resiliency and Prevention Programs for Mental and Behavioral Health in Service Members and Their Families

Preventing Psychological Disorders in Service Members and Their Families

Preventing Psychological Disorders in Service Members and Their Families

Preventing Psychological Disorders in Service Members and Their Families

Preventing Psychological Disorders in Service Members and Their Families

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations

Strengthening the Military Family Readiness System for a Changing American Society

Strengthening the Military Family Readiness System for a Changing American Society

Strengthening the Military Family Readiness System for a Changing American Society

Strengthening the Military Family Readiness System for a Changing American Society

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations

Returning Home from Iraq and Afghanistan

Returning Home from Iraq and Afghanistan

Substance Use Disorders in the U.S. Armed Forces

Substance Use Disorders in the U.S. Armed Forces

Evaluation of the Department of Veterans Affairs Mental Health Services

Evaluation of the Department of Veterans Affairs Mental Health Services

Strengthening the Military Family Readiness System for a Changing American Society

Strengthening the Military Family Readiness System for a Changing American Society

Provision of Mental Health Counseling Services Under TRICARE

Provision of Mental Health Counseling Services Under TRICARE

Preparing for the Psychological Consequences of Terrorism

Preparing for the Psychological Consequences of Terrorism

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