A new standard of care proposed by RAND researchers aims to redefine high-quality care for veterans with a traumatic brain injury or posttraumatic stress disorder. But it also could serve as a template for making health care more effective, more consistent, and more responsive for more patients.
Terri Tanielian, a senior behavioral scientist at RAND and an internationally recognized expert on military and veteran health, spent six months as a fellow with the House Committee on Veterans' Affairs. She helped the committee develop a comprehensive suicide prevention strategy.
Many post-9/11 veterans who have PTSD or depression also struggle with substance use. There are clinically proven treatments to help break the cycle of the co-occurring disorders, but the VA and other facilities need guidance on how to expand and enhance treatment opportunities for these veterans.
Millions of post-9/11 U.S. military veterans experience life-changing invisible wounds, including posttraumatic stress disorder and chronic issues resulting from traumatic brain injuries. While effective treatments are available, many veterans lack access to high-quality care. And what high-quality care means, exactly, has been elusive.
It is not uncommon to see a co-occurrence of PTSD and heavy use of substances, which can rise to the level of a substance use disorder. It may be necessary to challenge how the needs of veterans are addressed to remove barriers to care that make treating these co-occurring disorders simultaneously so difficult.
Deployed civilians often work alongside the military in combat zones or other high-stress, high-risk areas. But when they return, their experience is much different. They come home to support that is often incomplete and insufficient, and sometimes entirely nonexistent.
A decade of research at RAND has sought to focus the national conversation about suicide in general, and veteran suicide in particular, around solutions that work. The overwhelming message: We could do more to save the lives of veterans like Daniel Somers. Here is his story.
School shootings leave wounds that affect students, school staff, families, and communities for years. Building community resilience, implementing evidence-based mental health support early, and providing access for survivors and the community immediately and in the long term could help promote healing and prevent more tragedy.
A program developed at RAND helps children exposed to trauma confront and subdue their stress and anxiety. The program grew out of the 1990s street violence of South Los Angeles and has since helped kids from Newtown to Fukushima. Researchers are tailoring this intervention for children in Puerto Rico whose lives were upended by hurricanes.
The need for mental health support and suicide-prevention efforts targeting survivors of mass shootings, and the friends and families of victims, is great. Putting such programs in place could go a long way toward helping them heal, and preventing more tragedy.
Millions of veterans and service members receive care from family and friends who need support as well. Military caregivers sacrifice their time, their jobs, and even their health to provide a service worth billions of dollars to the United States.
Too few of the veterans who experience mental health issues get the help they need. Even fewer get the right care. Closing these gaps will require raising awareness about the barriers to care, and changing how the mental health care system is organized and delivers services.
The United States has made life-saving progress on crisis support for veterans. Now other suicide prevention services need help. Progress made by the VA could provide a blueprint for improving suicide prevention services for all Americans.
Today, women represent approximately 15 percent of the U.S. military but research on their specific physical and psychological health issues has remained relatively sparse. A new book, Women at War, attempts to change that.
For frontline civilians, daily life built around war often involves waking up on a remote base and working side by side with soldiers in hazardous places. They often don't get the care and support that they need, whether in an area of crisis and instability, or when they return home.
Reaching veterans to learn more about their mental health care seeking poses a conundrum. They are typically recruited for studies in clinical settings, so those who are not seeking care are not represented. Facebook may be a viable method to reach them.
Researchers have made great progress capturing the consequences of coping with injuries sustained in the theater of war, but the emerging picture is shadowed in grays. A series of recent findings presents a bleak portrait of the cost of modern war to service members, their families, and their health care providers.
Collaborative care has been an important part of Army efforts to reach out to those struggling with PTSD and depression. It has brought a science-based solution to an essential military problem and has helped thousands of men and women in uniform in ways that also nudge the larger mental health system toward greater effectiveness for all Americans.
What's happening in the mental health world of the U.S. military and veterans is of great interest to all American psychiatrists. The local impact of recent deployments to Iraq and Afghanistan runs much deeper than just the number of veterans in a particular practice or community.
The landscape for caregivers remains very difficult. Many still need additional training on how to best provide care for their loved ones, respite so they can care for themselves, and other forms of support.
A world without military caregivers would be a harsher one for all, particularly for those who have served. Military caregivers' sacrifices improve the lives of wounded, ill, and injured service members and veterans, more of whom would suffer without them.
Kayla Williams describes her difficult transition from soldier to spouse, sergeant to civilian, team leader to caregiver. Two books by military wives opened her eyes to the challenges and rewards of marrying into the military, and the unique kind of service military families experience.
The needs of U.S. veterans will not end when the war does; they will just be beginning. Though over a lifetime veterans are more highly educated, employed, and paid than their civilian counterparts, the period of reintegration can be challenging.
In contrast to the numerous mental health resources available to members of the U.S. military, very few (if any) resources are available to help private contractors struggling with mental health problems. It is in the best interest of all involved to ensure that contractors receive the support and treatment they need.
Military families play a critical role in supporting U.S. servicemembers during deployment and afterwards. Equally vital but often less visible is the role played by those who care for the servicemembers who return with disabling injuries or illnesses and require long-term support beyond what the formal health care system provides.
Ensuring the availability of needed mental health resources was critical in the immediate aftermath and recovery phase of the 2011 Joplin, Missouri tornado. Authorities in Oklahoma must ensure that such services are in place early so that Moore's residents can begin the long journey to recovery.
The toll of the tornado on school students in Moore, Oklahoma, cannot be overstated. To assist with recovery, RAND's CBITS program offers resources on psychological first aid for schools, as well as additional materials for educators and parents.
While our research has taught us many things about suicide prevention we think additional research is critically needed in two areas, writes Rajeev Ramchand. The first is gun control. The second area is the quality of behavioral health care available to those who need it.
Ret. Gen. Peter Chiarelli, who was Army vice chief of staff, discusses why he disagrees with the idea that the post-traumatic stress soldiers suffer is a disorder with RAND president and CEO Michael Rich at RAND's Politics Aside event.
While many of these families fight for honor and respect from the DoD or support from the VA, the comfort that they need will not be provided by either institution, nor should it be. Rather, it is up to us—as their neighbors, coworkers, teachers, and students—to shower these families with the love and support they need and deserve, writes Rajeev Ramchand.
June is National PTSD Awareness Month and June 27th is PTSD Awareness Day, providing an opportunity to recognize the challenges faced by survivors of trauma who live with PTSD symptoms. RAND research is helping increase awareness about the disorder and inform policy about how to prevent and address it.
As Post-Traumatic Stress Disorder (PTSD) Awareness Day approaches on June 27th, policymakers continue to look for ways to best help our nation's servicemembers and veterans with PTSD and other combat related mental health problems.
The military is experiencing a higher number of suicides than it has ever experienced at this time before. RAND research has a number of recommendations to prevent suicide among military personnel based.
The impact of violence and trauma on children has led RAND and its partners to focus not only on studying the problem, but working collaboratively to find interventions that help address a significant public health need.
In recognition of National Mental Health Month, May 2012, we spotlight posttraumatic stress disorder (PTSD) and RAND's work to advance understanding and treatment of this condition, which affects many more people than is commonly thought.
Delivery of evidence-based care to all veterans with PTSD or depression would pay for itself—or even save money—within two years by improving productivity and reducing medical and mortality costs, writes Terri Tanielian.
Not only would the delivery of quality behavioral care prevent suicides, but it would also aid in the recovery of the nearly 20 percent of service members with post-traumatic stress disorder or depression, writes Rajeev Ramchand.
Nearly 300,000 Iraq and Afghanistan service veterans who have returned home -- about one in five -- may suffer from combat-stress-related mental health problems. Our veterans ought to get the best available treatments our nation can offer, but they don't, write authors Terry Schell, Terri Tanielian and Lisa Jaycox.