Kimberly A Hepner

When the demand for behavioral health care outstrips supply at military treatment facilities (MTFs), service members are referred to private-sector providers. While readiness assessments are routinely included in clinical encounters at MTFs, it has been unclear how readiness assessments and command communication are being conducted for service members receiving private-sector care.

The authors compare the Department of Defense's health readiness assessments against their stated objectives and identify potential opportunities for improvement and increased efficiencies.

Delivery of high-quality behavioral health (BH) care is essential to the readiness of the U. S. armed forces and their families. Virtual behavioral health (VBH) care expanded during the COVID-19 pandemic and could support BH care delivery in the future. The authors examined trends in the use of VBH care for U. S. Army soldiers and their spouses from prior to the pandemic through March 2022 and surveyed soldiers about their perceptions of VBH care.

Acute and chronic pain are common among service members, with musculoskeletal pain and injuries being the leading cause of nondeployability among active-duty service members. Interviews with Military Health System (MHS) administrators, providers, and service member patients provide on-the-ground perspectives on MHS pain care policies, highlighting strengths and potential areas for improvement and innovation in pain care across the MHS.

This report examines changes in behavioral health care delivered to service members by the Military Health System following the onset of the COVID-19 pandemic, including patterns of care, use of telehealth, and quality of care. The findings and recommendations are intended to inform improvements to behavioral health care in the Military Health System and provide insights into the implications of its ongoing integration of telehealth.

Building on prior RAND research that found inconsistencies in how behavioral health technicians (BHTs) were integrated across the Military Health System, researchers surveyed military BHTs and licensed mental health providers who work alongside them to gain insights on BHTs? contributions, training and supervision, and job satisfaction, as well as barriers to better integrating them into clinical practice.

Behavioral health (BH) conditions comprise the second most common medical reason for nondeployability in the U. S. Army. To inform the Army's efforts to monitor and improve outcomes, the authors aimed to identify promising metrics to assess readiness among soldiers and adult family members who receive BH care. Such metrics would expand the Army's outcome monitoring efforts beyond symptom improvement metrics for patients who received BH care.

This report is a comprehensive assessment of the quality of care delivered by the Military Health System (MHS) in 2013-2014 for active-component service members with posttraumatic stress disorder (PTSD) or depression. The assessment includes performance on 30 quality measures, which draw on multiple data sources to evaluate the receipt of recommended assessments and treatments. The assessment identified strengths and areas for improvement.

This report identifies factors associated with changes in outcomes for soldiers who received Army behavioral health specialty care and provides recommendations to improve care and outcomes for posttraumatic stress disorder, depression, and anxiety. Analyses of 141 patient and treatment variables indicated that two treatment factors-therapeutic alliance and receipt of benzodiazepines-were associated with outcomes.

The Training in Psychotherapy (TIP) Tool can be applied to community-based psychotherapy trainings to assess the extent to which their features align with core elements that enhance effectiveness. This document includes the TIP Tool, a user guide, and details on the development of the tool.

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.

Understanding the current quality of care for posttraumatic stress disorder (PTSD) and depression delivered to service members is an important step toward improving care across the Military Health System (MHS). This report describes the characteristics of active-component service members who received care for PTSD or depression through the MHS and assesses the quality of care received using quality measures derived from administrative data.

To inform improvements to the quality of care delivered by the military health system for posttraumatic stress disorder and major depressive disorder, researchers developed a framework and identified, developed, and described a candidate set of measures for monitoring, assessing, and improving the quality of care. This document describes their research approach and the measure sets that they identified.

This report presents results of an implementation evaluation of a clinician training program to improve care for Navy personnel with co-occurring disorders. Clinicians saw a need for such training and viewed it positively. Results also suggest that careful planning and targeting training towards programs best suited to treating co-occurring disorders would improve training effectiveness and likely translate into higher-quality care.