Committee on the Initial Assessment of Readjustment Needs of Military Personnel, Veterans, and Their Families's Books

Returning Home from Iraq and Afghanistan

Preliminary 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 Initial Assessment of Readjustment Needs of Military Personnel, Veterans, and Their Families

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Returning Home from Iraq and Afghanistan

Preliminary 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 Initial Assessment of Readjustment Needs of Military Personnel, Veterans, and Their Families

Nearly 1.9 million U.S. troops have been deployed to Afghanistan and Iraq since October 2001. Many service members and veterans face serious challenges in readjusting to normal life after returning home. This initial book presents findings on the most critical challenges, and lays out the blueprint for the second phase of the study to determine how best to meet the needs of returning troops and their families.

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192

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National Academies Press

Published Date

ISBN 10

0309147638

ISBN 13

9780309147637

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

ISBN 13

9780309264273

Returning Home from Iraq and Afghanistan

Preliminary 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 Initial Assessment of Readjustment Needs of Military Personnel, Veterans, and Their Families

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Returning Home from Iraq and Afghanistan

Preliminary 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 Initial Assessment of Readjustment Needs of Military Personnel, Veterans, and Their Families

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193

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National Academies Press

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ISBN 10

0309152852

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9780309152853

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

ISBN 13

9780309301763

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

Published Date

ISBN 10

0309297184

ISBN 13

9780309297189

Strengthening Data Science Methods for Department of Defense Personnel and Readiness Missions

By: National Academies of Sciences, Engineering, and Medicine,Division on Engineering and Physical Sciences,Board on Mathematical Sciences and Their Applications,Committee on Applied and Theoretical Statistics,Committee on Strengthening Data Science Methods for Department of Defense Personnel and Readiness Missions

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Strengthening Data Science Methods for Department of Defense Personnel and Readiness Missions

The Office of the Under Secretary of Defense (Personnel & Readiness), referred to throughout this report as P&R, is responsible for the total force management of all Department of Defense (DoD) components including the recruitment, readiness, and retention of personnel. Its work and policies are supported by a number of organizations both within DoD, including the Defense Manpower Data Center (DMDC), and externally, including the federally funded research and development centers (FFRDCs) that work for DoD. P&R must be able to answer questions for the Secretary of Defense such as how to recruit people with an aptitude for and interest in various specialties and along particular career tracks and how to assess on an ongoing basis service members' career satisfaction and their ability to meet new challenges. P&R must also address larger-scale questions, such as how the current realignment of forces to the Asia-Pacific area and other regions will affect recruitment, readiness, and retention. While DoD makes use of large-scale data and mathematical analysis in intelligence, surveillance, reconnaissance, and elsewhereâ€"exploiting techniques such as complex network analysis, machine learning, streaming social media analysis, and anomaly detectionâ€"these skills and capabilities have not been applied as well to the personnel and readiness enterprise. Strengthening Data Science Methods for Department of Defense Personnel and Readiness Missions offers and roadmap and implementation plan for the integration of data analysis in support of decisions within the purview of P&R.

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165

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National Academies Press

Published Date

ISBN 10

0309450810

ISBN 13

9780309450812

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

Published Date

ISBN 10

0309466601

ISBN 13

9780309466608

The Air Force Health Study Assets Research Program

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Management of the Air Force Health Study Data and Specimens--Report to Congress

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The Air Force Health Study Assets Research Program

By: Institute of Medicine,Board on the Health of Select Populations,Committee on the Management of the Air Force Health Study Data and Specimens--Report to Congress

The Air Force Health Study (AFHS) is a longitudinal, prospective epidemiologic study of more than 2,700 men followed for approximately 20 years. This cohort participated in up to six intensive physical examinations with high rates of compliance. In addition to a complete record of clinical measurements and observations collected at these exams, serum and other biological samples were obtained and preserved. Extensive questionnaires addressing health, lifestyle, and socioeconomic status were administered during each exam, and other information was obtained about the participants' employment, families and offspring, and potential sources of environmental exposures. While the study was completed in 2006, the extensive health data linked to several types of longitudinally collected biologic specimens - some 91,000 serum, whole blood, urine, semen, and adipose tissue specimens - remain a resource for additional research. The AFHS assets are exceptional in the sheer multitude and range of types of information available for each participant. The longitudinal nature of the AFHS - with its extended follow-up, high rates of retention, and repeat biological samples - provides a valuable opportunity for research beyond the original aims of the study. Currently, the Institute of Medicine is the custodian of these assets. The Air Force Health Study Assets Research Program outlines the feasibility and advisability of maintaining the biospecimens based on interest generated from the general scientific community and results of pilot projects and other research projects using the AFHS assets. According to this report, sustaining access to the AFHS biospecimens and data benefits the veterans community and the public at large, who will gain from the information derived from studies of the assets. . This report discusses the scientific value of the AFHS data and biospecimens and the lessons learned in managing access to the assets.

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202

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National Academies Press

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ISBN 10

0309339170

ISBN 13

9780309339179

Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Population Health and Public Health Practice,Board on the Health of Select Populations,Committee on the Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry

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Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry

Military operations produce a great deal of trash in an environment where standard waste management practices may be subordinated to more pressing concerns. As a result, ground forces have long relied on incineration in open-air pits as a means of getting rid of refuse. Concerns over possible adverse effects of exposure to smoke from trash burning in the theater were first expressed in the wake of the 1990â€"1991 Gulf War and stimulated a series of studies that indicated that exposures to smoke from oil-well fires and from other combustion sources, including waste burning, were stressors for troops. In January 2013, Congress directed the Department of Veterans Affairs (VA) to establish and maintain a registry for service members who may have been exposed to toxic airborne chemicals and fumes generated by open burn pits. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry analyzes the initial months of data collected by the registry and offers recommendations on ways to improve the instrument and best use the information it collects. This report assesses the effectiveness of the VA's information gathering efforts and provides recommendations for addressing the future medical needs of the affected groups, and provides recommendations on collecting, maintaining, and monitoring information collected by the VA's Airborne Hazards and Open Burn Pit Registry.

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253

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National Academies Press

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ISBN 10

0309451205

ISBN 13

9780309451208

Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Population Health and Public Health Practice,Committee on the Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations

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Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations

More than 3.7 million U.S. service members have participated in operations taking place in the Southwest Asia Theater of Military Operations since 1990. These operations include the 1990-1991 Persian Gulf War, a post-war stabilization period spanning 1992 through September 2001, and the campaigns undertaken in the wake of the September 11, 2001, attacks. Deployment to Iraq, Kuwait, Saudi Arabia, Bahrain, Gulf of Aden, Gulf of Oman, Oman, Qatar, the United Arab Emirates, and Afghanistan exposed service members to a number of airborne hazards, including oil-well fire smoke, emissions from open burn pits, dust and sand suspended in the air, and exhaust from diesel vehicles. The effects of these were compounded by stressors like excessive heat and noise that are inevitable attributes of service in a combat environment. Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations reviews the scientific evidence regarding respiratory health outcomes in veterans of the Southwest Asia conflicts and identifies research that could feasibly be conducted to address outstanding questions and generate answers, newly emerging technologies that could aid in these efforts, and organizations that the Veterans Administration might partner with to accomplish this work.

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271

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National Academies Press

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ISBN 10

0309679109

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9780309679107

Taking Action Against Clinician Burnout

A Systems Approach to Professional Well-Being

By: National Academies of Sciences, Engineering, and Medicine,National Academy of Medicine,Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being

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Taking Action Against Clinician Burnout

A Systems Approach to Professional Well-Being

By: National Academies of Sciences, Engineering, and Medicine,National Academy of Medicine,Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being

Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.

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335

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National Academies Press

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ISBN 10

0309495474

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9780309495479

Book's by Committee on the Initial Assessment of Readjustment Needs of Military Personnel, Veterans, and Their Families

Returning Home from Iraq and Afghanistan

Returning Home from Iraq and Afghanistan

Returning Home from Iraq and Afghanistan

Returning Home from Iraq and Afghanistan

Returning Home from Iraq and Afghanistan

Returning Home from Iraq and Afghanistan

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations

Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations

Preventing Psychological Disorders in Service Members and Their Families

Preventing Psychological Disorders in Service Members and Their Families

Strengthening Data Science Methods for Department of Defense Personnel and Readiness Missions

Strengthening Data Science Methods for Department of Defense Personnel and Readiness Missions

Evaluation of the Department of Veterans Affairs Mental Health Services

Evaluation of the Department of Veterans Affairs Mental Health Services

The Air Force Health Study Assets Research Program

The Air Force Health Study Assets Research Program

Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry

Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry

Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations

Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations

Taking Action Against Clinician Burnout

Taking Action Against Clinician Burnout

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