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سد الثغرات في العناية بالصحة العقلية: الدروس المستفادة من مبادرة الترحيب بالمحاربين القدامى

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Research Questions

  1. What programs provide access to mental health care for veterans and their families?
  2. What are the WBV programs?
  3. How do these programs go about addressing their mission?
  4. How do these activities fit within the larger context of the nation's evolving systems of care that address mental health issues for veterans and their families?

Over the past decade, there have been a growing number of efforts designed to support service members, veterans, and their families as they cope with deployments. Addressing the mental health consequences associated with these deployments has been a priority focus area across the government and nongovernment sectors. The Welcome Back Veterans (WBV) initiative was launched in 2008 by Major League Baseball and the Robert R. McCormick Foundation to support organizations that, in turn, provided programs and services to support veterans and their families. Since WBV's founding, it has issued grants to academic medical institutions around the nation to create and implement programs and services designed to address the mental health needs of returning veterans and their families. Since 2013, WBV has made strides in assisting service members, veterans, and families and in facilitating collaboration among systems of care in local communities. However, strategic efforts are needed to promote sustainability and address emerging challenges as individual programs move toward greater coordination with others in the system of care for veterans. WBV grantees and other programs must continue adapting to sustain their mental health service offerings to meet the demand for care but also to improve integration and coordination. Expanding collaborative networks and adopting a system-of-systems approach may help private mental health care programs like WBV continue to build capacity and have a positive effect going forward.

Key Findings

WBV Grantees Are Located Around the United States and Focused on Addressing the Mental Health Needs of Service Members, Veterans, and Their Families

  • Seven sites across the United States — California, Georgia, Illinois, Massachusetts, Michigan, New York, and North Carolina — use WBV funds to address needs and fill gaps in mental health services provided to military members and their families.

WBV Programs Offer a Range of Services

  • Grantees focused their services on maximizing impact and aligning with the WBV aim of establishing sustainable programs that support the mental health needs of service members, veterans, and families through public-private partnerships.
  • Activities were concentrated in four areas: delivering clinical services, training providers, raising public awareness, and creating referral networks.

Strategic Efforts Are Needed to Promote Sustainability and Address Emerging Challenges

  • As public and philanthropic support shifts and resources continue to decline following the drawdown of U.S. forces deployed overseas, programs must continue adapting to sustain offerings and meet the demand for care.
  • Improved use of telemedicine, information technology, and public-private partnerships are promising approaches for bolstering mental health access and quality.
  • Adopting a system-of-systems approach can serve to improve coordination, integration, and sustainability of these programs over time.

Recommendations

  • Incorporating WBV programs into a system-of-systems approach allows autonomous but interrelated organizations to operate as components of a greater, multifaceted system.
  • Common measures are needed to evaluate inputs, outputs, outcomes, and impact of programs and training efforts across all community based mental health programs for veterans and their families.
  • Better-coordinated performance measurement and communication across the WBV initiative and across the nongovernmental systems may help each organization learn from others' experiences and adopt best practices.
  • Continuous performance improvement focuses on processes and service and can help programs more effectively collaborate with external partners, enhance quality of care and service delivery, improve job satisfaction for health care personnel, and establish more efficient processes.
  • Continuous quality improvement is a management philosophy that seeks to enhance the quality of services and products though process improvement and performance measurement, which might improve WBV processes and outcomes.
  • Strategic planning is needed to make the necessary changes, build the appropriate infrastructure, and make the arrangements and investments to support these programs in the long term.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Understanding and Influencing Federal Health Systems of Care for Mental Health

  • Chapter Three

    Role of WBV Initiative in Strengthening Systems and Extending Community Capacity

  • Chapter Four

    Understanding a Rapidly Emerging and Evolving Landscape

  • Chapter Five

    Looking to the Future: Facilitating a System-of-Systems Approach

This research presented in this report was sponsored by the Robert R. McCormick Foundation and conducted within RAND Health.

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