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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.
Behavioral health disparities, in which socially disadvantaged groups such as racial/ethnic minorities, women, and sexual orientation minorities experience greater risk for certain mental health and substance use problems, are well documented in the general population. Less is known about whether similar behavioral health disparities exist among military service members. The U.S. Department of Defense (DoD) wanted to understand whether the behavioral health disparities seen in the civilian population also exist in the military, which is important to help DoD target its efforts to address the needs of service members and improve force readiness. To investigate this issue, RAND researchers examined the following: (1) whether minority group service members are more likely to experience mental health and substance use problems relative to their majority counterparts in the military and (2) whether minority-majority group differences in behavioral health within the military are similar or different from those in the civilian population. Any minority-majority group differences observed in the military were tested to see if they remain after accounting for sociocultural environmental factors (e.g., demographics, social support, harassment). Identifying where behavioral health disparities exist among military minority service groups and the factors that may be associated with observed disparities can help DoD better target efforts to address the behavioral health needs of its troops. Further, if minority group disparities are greater in the military than in the civilian population, this might signal the presence of factors specific to the military context that may exacerbate minority group service members' risk for behavioral health conditions. The study used data from the 2015 Health Related Behavior Survey (HRBS), the 2015 National Survey on Drug Use and Health (NSDUH), the 2015 and 2016 Behavioral Risk Factor Surveillance System (BRFSS), and the 2015 National Health and Nutrition Examination Survey (NHANES). Behavioral health conditions included mental health (i.e., depression, suicide behaviors, posttraumatic stress disorder) and substance use (i.e., problematic alcohol use, tobacco use) outcomes.
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.
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.
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.
In this report, RAND researchers review survey methods, sample demographics, key findings, and policy implications from the 2015 Health Related Behaviors Survey of active-duty service members.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
The challenges facing military veterans who return to civilian life in the United States are persistent and well documented. But for all the political outcry and attempts to improve military members' readjustments, veterans of all service eras face formidable obstacles related to mental health, substance abuse, employment, and — most damningly — homelessness. Homelessness Among U.S. Veterans synthesizes the new glut of research on veteran homelessness — geographic trends, root causes, effective and ineffective interventions to mitigate it — in a format that provides a needed reference as this public health fight continues to be fought. Codifying the data and research from the U.S. Department of Veterans Affairs (VA) campaign to end veteran homelessness, psychologist Jack Tsai links disparate lines of research to produce an advanced and elegant resource on a defining social issue of our time.
This report summarizes the findings of a study to construct item banks of barriers and facilitators to mental health care for the U.S. Department of Defense.