Mental Health Care for Iraq and Afghanistan War Veterans Audrey Burnam, Lisa Meredith, Terri Tanielian, Lisa Jaycox

A /09 Few Veterans Who Need Mental Health Care Receive Even Minimally Adequate Treatment SOURCE: T.L. Tanielian and L.H. Jaycox, (Editors). “Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery,” (pp. 101 & 103). RAND MG-720-CCF. Santa Monica, CA: RAND Corporation (2008). NOTES: MH is mental health. A MH problem is defined as meeting scoring criteria on a survey for probable diagnosis of PTSD or depression. Minimally adequate treatment is defined as at least 8 sessions averaging 30 minutes in duration for those reporting psychotherapy, and at least 4 visits with a doctor and staying on medication as long as the doctor recommended for those on medication over the prior year. 8.8% 4.1% 5.6% 81.5% MH problem, no treatment MH problem, any treatment MH problem, minimally adequate treatment No MH problem

A /09 Key Challenges   Gaps in Access to Care   Veterans need care in their home communities, but it is not readily available in many parts of U.S.   Servicemembers often reluctant to seek care; military culture and institutions play a role   Gaps in Quality of Care   MH workforce often not trained to meet common core standards or competence in best practices   Organizational systems and tools to support quality improvement in mental health not widely used

A /09 What Else Can Be Done?  Confidential treatment options for servicemembers  Consumer education about treatment choices  MH workforce training and certification  Quality improvement systems and tools within DoD/Tricare  Technical assistance to states