Preventing Psychological Disorders in Service Members and Their Families An Assessment of Programs (2014) / Chapter Skim
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and the various military services have implemented programs and strategies designed to promote psychological health and resilience in an attempt to limit the degree to which combat exposure and the demands of service interfere with a service member's quality of life, service duties, and transition back to work and home. In addition, in recent years DOD and various communities have increased support for military families by offering familyfocused programs aimed at behavioral health, quality of life, and other support services.
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and reviewed existing performance measures from three sources that are the products of national efforts to organize, manage, and promulgate the use of performance measures: the National Behavioral Health Quality Framework, developed by the Substance Abuse and Mental Health Services Administration; the NQF Quality Positioning System; and the National Quality Measures Clearinghouse, maintained by the Agency for Healthcare Research and Quality.
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Prevention efforts aligned with health promotion emphasize fostering well-being with a goal of helping individuals lead healthy, thriving lives. In this view, the target of prevention programs is not only to prevent psychological health problems but also to promote positive psychological health, defined as a state of well-being in which persons can realize their abilities, cope with life's stresses, and work regularly and productively.
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As DOD advances its efforts to evaluate and improve psychological health programming for service members and their families, it faces a number of challenges, such as insufficient empirical evidence for many of the prevention programs it has implemented, the fact that there has been no systematic use of national performance measures to assess current DOD screening programs, and the lack of a systematic process to select validated measures for use in judging the performance of the structure, process, and outcomes of all prevention initiatives for enhancing psychological health. The measurement of performance is not as advanced in psychological health as it is in other types of care.
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Where programming needs exist and the evidence base is insufficient, DOD should use rigorous methods to develop, test, monitor, and evaluate new programming. RISK IDENTIFICATION AND INTERVENTION DOD implements systematic screening processes to identify service members at risk for a specific psychological health problem annually and at various points in the military life cycle -- at accession (entrance into the military)
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In addition, the committee found that although DOD conducts systematic psychological health screening of service members at various phases in the military life cycle as well as in primary care clinics, it does not have a routine health screening program targeting service members who are about to separate from the military. With appropriate processes for referral and for the coordination of care between the military health system and non-military health providers, including the Veterans Health Administration, screening at separation may help to improve reintegration back into civilian life.
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The committee's review of programs in this study and its review of recent comprehensive assessments of military family programs share the common finding that there are gaps in the evidence supporting the effectiveness of interventions for military families. The committee recognizes there are initiatives in place to build the research base in family-focused programs, but believes a more coordinated, comprehensive and systematic approach is needed to support the development and implementation of evidence-based prevention programming for military spouses, partners, and children that address risk and vulnerabilities specific to particular points in the military life cycle.
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creating procedures for discontinuing ineffective or duplicative programs and for implementing programs demonstrated to be highly effective, costeffective, and culturally diverse. The reporting of these functions for transparency and accountability purposes is a critical component to ongoing program quality improvement.
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