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Research Questions

  1. What is the current status of well-being among the Air Force's wounded warriors?
  2. To what extent do the Air Force's wounded warriors use the Air Force programs designed to serve them?
  3. How satisfied are they with these programs?

The U.S. Air Force, wanting to gain greater insight into the well-being of its members who have sustained mental or physical injuries in combat or combat-related situations, including their quality of life and the challenges they will confront in their reintegration following separation or retirement, asked the RAND Corporation for assistance in gauging the current status of the Air Force's wounded warriors, including their use of and satisfaction with Air Force programs designed to serve them. This report presents the baseline findings from a longitudinal analysis of enrollees in the Air Force Wounded Warrior (AFW2) program who were receiving benefits or undergoing evaluation to receive benefits, the majority of whom had a primary administrative diagnosis of post-traumatic stress disorder (PTSD). A high proportion of the Airmen in the sample screened positive for PTSD (roughly 78 percent) and major depressive disorder (MDD) (roughly 75 percent); 69 percent screened positive for both. Although more than 90 percent of those in the sample who screened positive for PTSD or MDD were receiving treatment, about half indicated that there was at least one instance during the past year in which they desired mental health treatment but did not receive it. Participants reported concerns about stigma, confidentiality, and the quality of available treatment as barriers to receiving mental health care, though the current data do not link these concerns to a particular treatment setting. About 10 percent of Airmen reported a financial situation that could be considered as living in poverty based on U.S. Department of Health and Human Services' poverty guidelines. Similarly, close to 15 percent of those in the labor force could be considered unemployed. Reserve and National Guard Airmen evidenced heightened challenges across examined domains. Respondents were overall satisfied with the services they received from the AFW2 and Air Force Recovery Care Coordinator programs.

Key Findings

Airmen Are Indeed Experiencing Challenges in a Number of Domains

  • Roughly 78 percent of the Airmen in our sample screened positive for post-traumatic stress disorder (PTSD), while about 75 percent screened positive for major depressive disorder (MDD); 69 percent screened positive for both.
  • Although those in the sample who screened positive for PTSD or MDD reported very high rates of mental health treatment within the past year, about half indicated that there was at least one instance during that time in which they desired mental health treatment but did not receive it.
  • There are concerns among Airmen about the quality of available mental health treatments and about the side effects of psychotropic medication.
  • About 10 percent of Airmen reported a financial situation that could be considered as living in poverty according to U.S. Department of Health and Human Services guidelines.
  • Close to 15 percent of Airmen would be considered unemployed based on the U.S. Bureau of Labor Statistics' U3 measure of unemployment.
  • Almost 10 percent of the entire sample indicated that their first experience with housing instability occurred after their return from their most recent deployment.
  • Reserve and National Guard servicemembers evidenced heightened challenges across examined domains.

The Air Force Wounded Warrior and Air Force Recovery Care Coordinator Programs Appear to Work Well

  • High numbers of respondents indicated that they were receiving services from the programs for which they were eligible.
  • Respondents were receiving a number of services and reported overall satisfaction with the programs.

Recommendations

  • To increase Airmen's receipt of high-quality mental health care, the Air Force should inform Airmen about the quality of care available to them, emphasize and enhance confidential treatment options, and explore having nonmedical case managers help resolve scheduling difficulties encountered by Airmen seeking mental health treatment.
  • To help those Airmen who are unemployed, the Air Force should offer employment assistance that focuses on individual skill sets and their translation to new contexts and continue existing programs that have this individual focus.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Literature Review: A Holistic Approach to Reintegration Is Necessary

  • Chapter Three

    Survey Method

  • Chapter Four

    Survey Results

  • Chapter Five

    Conclusions and Recommendations

  • Appendix A

    Detailed Measures Information

  • Appendix B

    Survey Instrument

  • Appendix C

    Additional Results

Research conducted by

The research reported here was commissioned by the Assistant Secretary of the Air Force for Manpower and Reserve Affairs (SAF/MR); the Director, Air Force Directorate of Services (AF/A1S); and the Air Force Surgeon General (AF/SG). The analysis was conducted within the Manpower, Personnel, and Training Program of RAND Project AIR FORCE.

This report is part of the RAND Corporation research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

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