How Does RAND Define Programs that Address Psychological Health and Traumatic Brain Injury (TBI)?

What is a program and what kinds of programs are included in this Catalog?

Programs provide active services, interventions, or other interactive efforts that address psychological health or TBI care for members of the military community. Programs are distinct from clinical care services and non–clinical care services (e.g., services provided in chaplaincy or community and family support departments, including other services unrelated to psychological health and traumatic brain injury) though they may be housed in the same facility or organizational structure that provides these other types of services. Programs are also distinct from resources, a term that here refers to one-way, passive transmission of information (e.g., a directory that lists services available at an installation).

The conceptual framework figure is intended to illustrate the types of services and activities that are designated as programs that address psychological health and TBI. Taken as a whole, the figure illustrates the context in which programs and other types of health and support services occur. The left side of the figure focuses on existing clinical and nonclinical services provided to members of the military community, while the right side focuses on “special activities,” which are the array of activities focusing specifically on psychological health and TBI that are in addition to standard care. Given that clinical and nonclinical services are not mutually exclusive, the dashed line represents the range of services and care available. A similar dashed line suggests a parallel relationship between programs and resources.

RAND ART9015-3.1; Visual description of what a program

Inclusion Criteria

The activity focuses on improving psychological health and/or services related to traumatic brain injury. This includes a wide array of activities focusing on prevention or resilience; education and training; stigma reduction; improving access to care; or otherwise reducing barriers to obtaining care and treatment. It includes all relevant clinical issues, such as depression, PTSD, substance use, suicide prevention, general psychological health, and traumatic brain injury, as well as non-clinical issues that are often addressed by psychological health professionals, such as deployment-related issues, domestic violence, families and children, legal concerns, post-deployment and community or family reintegration, relationships, resilience, spiritual concerns, and stress reduction.

The activity is sponsored or funded by the Department of Defense, including through

  • any Department of Defense office, activity, agency, service, or command,
  • the VA/DoD Joint Incentive Funds (JIF),
  • any Department of Defense memorandum of understanding (MOU) or memorandum of agreement (MOA), or
  • funding by one of the branches of service.

The activity involves an intervention, efforts designed to affect a specific outcome, or the direct provision of services.

The activity has a target audience including active duty, National Guard, or Reserve component service members and/or their family members, or providers serving these individuals.

The activity conducts its efforts either in theater or out of theater, and was in operation at some point between December 2009 and August 2010.

New programs that come to our attention will be added on a continual basis until September 2013.

Exclusion Criteria

The activity includes an intervention that is not focused on psychological health and/or traumatic brain injury. This includes efforts such as day care, housing, family survivor programs not focused on psychological health (e.g., financial benefits programs), job training, entertainment, and construction projects.

The activity involves standard or routine care, such as clinical care at a military treatment facility, or focuses on standard clinical education (such as continuing medical education or internships).

The activity consists of screening tools that are not directly associated with an intervention, such as checklists and resources designed to help leaders recognize signs of psychological health problems.

The activity uses only one-way passive transmission of information without an intervention designed to affect a particular outcome. This may include, for example, websites that contain phone numbers for suicide prevention hotlines, efforts to distribute brochures, or task forces and committees.

The activity is a research project that does not involve an intervention (such as research designed to assess the prevalence of clinical conditions or utilization of services) or where the intervention is a clinical trial of a drug, treatment, or device.

The activity consists solely of laws, policies, Department of Defense instructions, memoranda or reports.

The activity is an advisory team, working group, advocacy group, task force, committee, or conference.

The activity is an administrative department, office, or center. If one of these organizations runs a program that itself meets the inclusion criteria, the program is included in this report, but the administrative department, office, or center is not. For example, some central Department of Defense offices set policies that are independently implemented by each branch of service. Since only the service-specific programs directly interact with service members and their families and meet our inclusion criteria, the central Department of Defense office would not be included.