I recently testified in front of the House Armed Services Subcommittee on Military Personnel. My conversation with members of Congress offered an excellent chance to highlight our efforts to promote psychological health and to prevent, diagnose and treat traumatic brain injury (TBI) in the military.
During my testimony, I gave important details about:
- The current state of evaluating treatment for mental health conditions and TBI
- Plans for the future of mental health and TBI research, treatment and outcomes
- Our plans to address opioid addiction in the military
I shared many of our accomplishments with the committee and I want to share a few with you below. I believe they reveal the important advances we made, provide an understanding of where we should target future research, and encourage more investments in medical research.
Mental Health and TBI Care
The Defense Department considers posttraumatic stress disorder (PTSD) and TBI leadership issues, with an emphasis on prevention. Through dedicated efforts, the Military Health System (MHS) reports:
- More access to care (a result of tripling our mental health staff).
- Decreases in PTSD incidents (from 17,000 to 14,000) and TBI incidents (from 31,000 to 23,000) from 2012 to 2015.
- Improvements in outpatient follow up. In fact, a recent RAND study validated our progress and found that we outperformed civilian health systems in outpatient follow-up after inpatient care for PTSD or depression.
One of our largest tasks is to learn why PTSD and TBI often present with depression, chronic pain, substance use disorders and suicide risk. Longitudinal research efforts, such as the 15-year study on TBI, provide a framework for creating effective rehabilitation and support programs.
Knowledge Translation and Program Evaluation
It’s critical that we take what we learn, from research and studies, and translate our findings to improve our medical practices. We developed an evidence-based knowledge translation process for use throughout the MHS. This capability provides a standardized process to use psychological health and TBI research to develop evidence-based practices and consistent standards of health care. We are optimistic that this process may also herald advancements in MHS practices beyond psychological health and TBI.
Additionally, it’s important to review current military programs to see what works and what doesn’t. We evaluated over 150 mental health, TBI, substance abuse and suicide prevention programs during the last five fiscal years. We hope to publish results of our five-year study later this fiscal year. These findings will help ensure the MHS focuses financial resources on programs that work, such as the U.S. Army Embedded Behavioral Health program and associated Behavioral Health Data Portal.
In 2015, more than 52,000 Americans died from a drug-related overdose. The Defense Department rate was much less. Why the difference? In short, our leaders focused on the well-being of service members and on outcome-based prevention efforts. These efforts include various prevention approaches, drug testing, provider training, pharmacy protections and medication therapies.
As you can see, we are making progress, but as I said during my testimony, we are not yet claiming victory. We hope to replicate some of the successes we've seen in PTSD and TBI incidents, and opioid overdose deaths, in other public health areas such as suicide prevention and alcohol use disorders.
The challenges faced by those we serve are life-long, and they demand our unwavering commitment to evidenced-based treatment, scientific research and discovery. We will keep moving forward!