The committee was impressed by the Army’s implementation of the Confidential Alcohol Treatment and Education Pilot (CATEP). CATEP attracted a broader range of patients (including higher-ranking officers) than is routinely seen in the Army Substance Abuse Program (ASAP). CATEP demonstrated that when given an opportunity for confidential treatment, greater numbers of active duty service members will seek care. Such programs should be expanded to all ASAP sites within the Army, as well as to the other branches. Policies should be updated to facilitate Command support for recovery through these confidential programs. The committee understands the need to balance health and discipline. Access to confidential brief counseling, brief treatment, and more intensive treatment promotes good care, reduces stigma, and builds resilience. Delivery of these services without sanctions would promote an effective response to alcohol and other drug use problems as they emerge and foster a system in which individuals seek help rather than hide problems. To promote increased utilization of SUD care, the committee makes the following recommendation:

Recommendation 8: DoD should encourage each service branch to provide options for confidential treatment of alcohol use disorders.

Over the last 10 years, the military has relied heavily on its reserve component (National Guard and Reserve) in the ongoing military operations in Iraq and Afghanistan. These individuals are at high risk for developing SUDs and in many cases lack continuity of care for ongoing mental health services once demobilized. In its review, the committee found a lack of access to SUD care for National Guard and Reserve members in particular and several needs pertaining specifically to this subpopulation. These needs include (1) mounting new programs to reach demobilized and discharged reserve component personnel, (2) making provisions for veterans with other than honorable discharges to receive outreach and continued SUD assessment and services by designated community-based providers, (3) providing options for the receipt of confidential screening and assessment in alternative venues to the Veterans Health Administration (VHA), (4) developing alternative procedures for reserve component demobilized and discharged veterans with elevated postdeployment health reassessment scores to receive a “warm hand-off” to a VHA or community-based provider with specialty training in serving veterans at risk of SUDs and/or suicide, (5) collaborating with the VHA to contract with community providers or existing programs (e.g., Military OneSource) to perform active outreach telephone contacts and facilitated linkage for particularly high-risk or difficult-tocontact reserve component members who are demobilized or discharged, and (6) funding research and evaluation on the most effective technologies and strategies for active engagement of high-risk reserve component members

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