Anxiety Disorders, Active Component, U.S. Armed Forces, 2000-2012 (October 2013): Anxiety is a normal reaction to stress; however, in individuals with anxiety disorder, the anxiety becomes chronic and exaggerated, and affects the physical and psychological health of the individual. The main types of anxiety disorders are generalized anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD), phobias, and obsessive-compulsive disorder (OCD). Incident diagnoses of anxiety disorders among active component service members steadily increased from 2000 to 2012. A majority of incident anxiety disorder diagnoses were "non-specific" anxiety disorders (ICD-9-CM codes: 300.0, 300.00, or 300.09) and over 75 percent of service members diagnosed with "non-specific" anxiety disorders did not have a more specific anxiety disorder diagnosis during subsequent medical encounters. Incidence rates of anxiety disorders were highest among females, white, non-Hispanics, in the youngest age groups, and among recruits and junior enlisted service members. About one-third of anxiety disorder cases also had a co-occurring diagnosis of either adjustment or depressive disorder within one year before or after the incident anxiety disorder encounter.
Multi-Disciplinary Brain Research (Sep 2013): The report addresses support of multi-disciplinary research toward translational medicine intended to provide better diagnostic tools and treatment outcomes for Service members who suffer from traumatic brain injury, post traumatic stress disorder, and other neurotrauma /neurological conditions, and on efforts made for the provision of capabilities necessary for researchers, scientists, surgeons, physicians, healthcare professionals, and patients to effectively communicate their findings and outcomes in near real-time.
DoD Directive: Defense Suicide Prevention Program (June 2013):This directive a. Establishes policy and assigns responsibilities for implementation of the Defense Suicide Prevention Program in accordance with the recommendations of the final report of the Department of Defense Task Force on Prevention of Suicide by Members of the Armed Forces (Reference (a)) pursuant to section 733 of Public Law (PL) 110-417 (Reference (b)),section 533 of PL 112-81 (Reference (c)), and sections 580-583 of PL112-239 (Reference (d)). b. Establishes the Suicide Prevention General Officer Steering Committee (SPGOSC) and the Suicide Prevention and Risk Reduction Committee (SPARRC) under the authority of DoD Instruction (DoDI) 5105.18 (Reference (e)).
Army Task Force on Behavioral Health Corrective Action Plan (2013): The Army has devoted an extraordinary amount of time, attention, and resources to care for Soldiers returning from deployments, especially those with behavioral health conditions. The Army continues to make great strides in changing the culture that stigmatized those with Post Traumatic Stress Disorder (PTSD) and to educate and encourage Soldiers and leaders to heal these invisible wounds of war. The Army has revised several policies to ensure Soldiers with PTSD are properly diagnosed, and if appropriate, considered for a medical discharge. Most recently, the Army proactively implemented several initiatives to resolve some of the findings discovered during the ATFBH comprehensive review. These changes are positive steps for our wounded, ill and injured, and this CAP details subsequent actions required to achieve a more efficient and effective disability system for Soldiers with behavioral health conditions.
Commander's Legal Handbook (Judge Advocate General's Legal Center and School, U.S. Army) (2012): This Handbook is designed to assist you in taking proper immediate action when faced with a variety of legal issues that might arise during your command. The purpose of your actions should be to preserve the legal situation until you can consult with your serving Judge Advocate. However, like most aspects of your command responsibilities, you can fail if you just wait for things to come to you. You need to be proactive in preventing problems before they occur.
Demographics Report (2012 edition): Annual demographic report on members and families in the military community. (2011 edition)
Department of Defense Suicide Event Reports (2012-2008 DoDSER editions): The DoDSER is used for a variety of suicide behaviors including suicides, suicide attempts, and some other suicide related behaviors (e.g., deliberate self-harm or some cases in which only suicidal ideation is documented). Each Service conducts a professional review of records, and conducts interviews where appropriate.
Military Family Readiness Report: Annual report to Congress; summary of plans and assessment activities pertaining to military family readiness.
Strategic Direction to the Joint Force on Sexual Assault Prevention and Response (May 2012): This Strategic Direction is written for commanders and leaders to improve awareness of sexual assaults, operationalize our commitment, and facilitate dialogue and open communications across our formations. The Joint Chiefs and Commandant of the Coast Guard, together with our DoD Sexual Assault Prevention and Response Program (SAPR) professionals, penned this guidance to synchronize those efforts. Together, we will operationalize the concerted efforts of the DoD SAPR Office and our Service programs with renewed commitment to eliminate sexual assault crimes within our ranks. Commanders and leaders at every level must integrate the intent, lines of effort and tenets of this Strategic Direction as a part of our daily command routines and activities. We must take conscious steps to understand, identify and reduce environmental risks, predatory and high-risk behaviors and personal vulnerabilities associated with sexual assaults or other abuse crimes.1 It is up to you, as commanders and leaders, to safeguard our core values and Service cultures by promoting a climate and environment that incorporates SAPR principles as habitual and inherent characteristics of our commands.
Report on the Impact of Deployment of Members of the Armed Forces on Their Dependent Children (2010): With the U.S. involvement in the conflicts in Afghanistan and Iraq ongoing, there is a deep concern over parental deployment and its impact on the well-being of military children. To better understand the current state of how military children cope with parental deployment, the Department conducted a comprehensive assessment of the impact of military deployment on children based on a review of available studies and survey data from OEF/OIF. Research from previous conflicts and relevant civilian literature were also included in the review.
Department of Defense Annual Report on Sexual Assault in the Military: To help address the crime of sexual assault within the Military, the Department of Defense and various Service branches conduct comprehensive annual sexual assault reports. The data provided in such reports serve as the foundation and catalyst for future sexual assault prevention, training, victim care and accountability goals.
National Leadership Summit on Military Families - Final Report (2010): The objectives of the Summit were to bring together those most knowledgeable about contemporary military family issues and challenges—and the programs/services in place to support service members and their families—to candidly discuss areas of strength, opportunities for improvement, and methods to enhance collaboration within and across the Department of Defense (DoD), the military services, USDA, the landgrant universities, and the Cooperative Extension Service. The Summit also challenged participants to identify barriers to effective support and to create specific action steps based on group consensus. The action steps developed at the Summit, which are described in this document, represent the participants’ collective vision about which areas in military family support must be considered top priorities and what specifically needs to be done to ensure (a) military family programs are relevant to the challenges families face today, and (b) programs are appropriately configured and resourced to produce meaningful, measurable outcomes.
Protecting the Force: Lessons From Fort Hood (January 2010): Following the tragic shooting at Fort Hood, Texas, on Nov. 5, 2009, Defense Secretary Robert M. Gates established the Department of Defense Independent Review Related to Fort Hood to examine the circumstances behind this tragedy. He directed that the assembled group to conduct the investigation and to report back to him by Jan. 15, 2010, with recommendations to identify and address possible deficiencies in: - the Department of Defense's programs, policies, processes, and procedures related to force protection and identifying DoD employees who could potentially pose credible threats to themselves or others; - the sufficiency of the Department of Defense's emergency response to mass casualty situations at DoD facilities and the response to care for victims and families in the aftermath of mass casualty events; - the sufficiency of programs, policies, processes, and procedures for the support and care of healthcare providers while caring for beneficiaries suffering from Post Traumatic Stress Disorder or other mental and emotional wounds and injuries; - the adequacy of Army programs, policies, processes, and procedures as applied to the alleged perpetrator. After conducting the review, the assembled group reached a number of conclusions and made corresponding recommendations. These recommendations are reflected in the full report which is available for download at the link below.
DoD OIG -- Observations and Critique of the DoD Task Force on Mental Health (April 2008): The DoD Task Force on Mental Health fully satisfied the intent and requirements of Section 723 of the Fiscal Year 2006 National Defense Authorization Act, and address Senator Lieberman’s concerns expressed in a May 17, 2006 letter. The task force report provided 15 findings and 95 recommendations to improve DoD’s mental health program for members of the Armed Forces and their families. The Secretary of Defense’s report to Congress summarized ongoing activity and provided target completion dates for recommendations. The Office of the Inspector General observer noted three topics raised by the task force that did not receive significant mention in the report: suicide, inpatient treatment, and physical evaluation boards/medical evaluation boards. These issues deserve continued attention. However, we concluded that the task force’s report and the report to Congress represent a comprehensive examination of DoD’s mental health care programs for members of the Armed Forces and their families. Management should organize and oversee resources to meet or improve the completion target dates listed in the Secretary of Defense’s report to Congress.
How the Army Runs: A Senior Leader Reference Handbook 2011-2012: This text is designed to explain and synthesize the functioning and relationships of numerous Defense, Joint, and Army organizations, systems, and processes involved in the development and sustainment of trained and ready forces for the Combatant Commanders. It is designed to be used by the faculty and students at the U.S. Army War College (as well as other training and educational institutions) as they improve their knowledge and understanding of “How the Army Runs.” We are proud of the value that senior commanders and staffs have placed in this text over the years and are pleased to continue to provide this reference.
Mental Health Advisory Team (MHAT) 7 Report: The Mental Health Advisory Teams (MHATs) were established by The Office of the Army Surgeon General and have deployed in support of Operation Iraqi Freedom six times since 2003 and to Operation Enduring Freedom four times, all at the request of theater commanders.
Department of Defense Annual Report on Sexual Assault in the Military: To help address the crime of sexual assault within the Military, the Department of Defense and various Service branches conduct comprehensive annual sexual assault reports. The data provided in such reports serve as the foundation and catalyst for future sexual assault prevention, training, victim care and accountability goals.
Department of Defense Survey of Health Related Behaviors Among Active Duty Military Personnel: The DoD Survey of Health Related Behaviors has been the predominate source of health behavior information for the military since 1980. The purpose of this population based survey is to continue to assess trends in a wide range of health behaviors in the military. The study assessed the prevalence of drug, alcohol and tobacco use, and assessed progress toward meeting HP2010 objectives. The survey also assessed general health status, mental health status, and access to, and utilization of, physical health and mental health services. Questions on special topics such as gender-specific issues, oral health, and deployment will be included.
Interagency Task Force on Military and Veterans Mental Health 2013 Interim Report: On August 31, 2012, the President signed an Executive Order directing the Departments of Veterans Affairs, Defense , and Health and Human Services, in coordination with other federal agencies, to take a number of steps to ensure that Veterans, Service Members, and their families receive the mental health services and supports they need. These steps include: ‒ Strengthening suicide prevention efforts across the Force and in the Veteran community ; ‒ Enhancing access to mental health care by building partnerships between the Department of Veterans Affairs (VA) and community providers; ‒ Increasing the number of VA mental health providers serving our Veterans; and ‒ Promoting mental health research and development of more effective treatment methodologies. This report summarizes the action steps the designated Federal Departments have undertaken in each of these areas.
The Challenge and the Promise: Strengthening the Force, Preventing Suicide and Saving Lives (August 2010): As directed by Section 733 of the National Defense Authorization Act for fiscal year 2009, the Secretary of Defense established a Task Force "to examine matters relating to the prevention of suicide by members of the Armed Forces." The Department of Defense Task Force on the Prevention of Suicide by Members of the Armed Forces was created and comprised of seven DoD and seven non-DoD professionals with expertise in national suicide prevention, clinical care in mental health, military chaplaincy and pastoral care, and military families. The report explains the evolution of suicide prevention programs within each of the Services and at the enterprise level with DoD. The Task Force arrived at 49 findings and 76 associated recommendations which are discussed within the body of the full report.
DoD OIG Evaluation of the Military Criminal Investigative Organizations' Sexual Assault Investigations (July 2013): We evaluated the Military Criminal Investigative Organizations’ (MCIOs’) sexual assault investigations completed in 2010 to determine whether they completed investigations as required by DoD, Military Service, and MCIO guidance. Our evaluation focused on the following question: Did the MCIOs investigate sexual assaults as required by guiding policies and procedures? Most MCIO investigations (89 percent) met or exceeded the investigative standards. We returned cases with significant deficiencies (11 percent) to the MCIOs for corrective action. Although 83 cases had no deficiencies, most of the remaining investigations had deficiencies that were not deemed significant. The U.S. Army Criminal Investigation Command (CID) and Air Force Office of Special Investigations (AFOSI) policy guidance does not direct the collection of clothing articles that a victim or suspect might have placed on themselves shortly after the assault, if different from the clothing worn during the assault. Naval Criminal Investigative Service (NCIS) policy does not require NCIS investigators to notify or coordinate with their servicing judge advocate(s) upon initiating an investigation. CID guidance regarding records checks does not provide a definitive timeliness requirement. NCIS policy on this topic needs improvement. NCIS needs policy to require Sexual Assault Response Coordinator (SARC) notifications and documentation.