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Military Mental Health Care
Aug 14, 2017
This report provides an overview of the psychological health workforce at military treatment facilities (MTFs), examines the extent to which care is consistent with clinical practice guidelines, and identifies facilitators and barriers to providing this care. This report offers a comprehensive assessment of providers' perspectives on their capacity to deliver care for PTSD and depression. Strategies to improve care in MTFs are described.
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Providing accessible, high-quality care for psychological health (PH) conditions, such as posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), is important to maintaining a healthy, mission-ready force. It is unclear whether the current system of care meets the needs of service members with PTSD or MDD, and little is known about the barriers to delivering guideline-concordant care. RAND used existing provider workforce data, a provider survey, and key informant interviews to (1) provide an overview of the PH workforce at military treatment facilities (MTFs), (2) examine the extent to which care for PTSD and MDD in military treatment facilities is consistent with Department of Veterans Affairs/Department of Defense clinical practice guidelines, and (3) identify facilitators and barriers to providing this care. This report provides a comprehensive assessment of providers' perspectives on their capacity to deliver PH care within MTFs and presents detailed results by provider type and service branch. Findings suggest that most providers report using guideline-concordant psychotherapies, but use varied by provider type. The majority of providers reported receiving at least minimal training and supervision in at least one recommended psychotherapy for PTSD and for MDD. Still, more than one-quarter of providers reported that limits on travel and lack of protected time in their schedule affected their ability to access additional professional training. Finally, most providers reported routinely screening patients for PTSD and MDD with a validated screening instrument, but fewer providers reported using a validated screening instrument to monitor treatment progress.
Chapter One
Introduction
Chapter Two
Methods
Chapter Three
Characteristics of the Psychological Health Workforce Across the MHS
Chapter Four
Delivery of Guideline-Concordant Care for PTSD and MDD
Chapter Five
Facilitators and Barriers to Provision of Guideline-Concordant Care for PTSD and MDD
Chapter Six
Summary and Recommendations
Appendix A
Survey Sampling and Weighting
Appendix B
Survey Domains
Appendix C
Survey of Psychological Heath Providers in the MHS
Appendix D
Key Informant Interview Discussion Guide
This research was sponsored by the Department of Defense's Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community.
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