NYAPRS Note: A new Pentagon-sanctioned IOM report indicates that an expensive preventative health model implemented by the military is not preventing mental health challenges. Preventative mental health strategies in any community is difficult to implement and assess, but for persons going into combat it is particularly difficult to mitigate, especially without ongoing resources for personnel during and immediately after deployment.
Report: Military Efforts to Prevent Mental Illness Ineffective
USA Today; Gregg Zoroya, 2/20/2014
There’s little evidence that the military’s efforts to prevent mental illness among troops are effective, a panel of scientists has concluded.
The military has produced dozens of programs aimed at preventing mental illness among troops during the wars in Iraq and Afghanistan, but there’s little evidence that most of them work, a blue-ribbon panel of scientists said in a report released Thursday.
The findings by a committee of 13 experts appointed by the Institute of Medicine of the National Academies come as about 1,000 Iraq- and Afghanistan-era veterans are being diagnosed with post-traumatic stress disorder each week, according to data from the Department of Veterans Affairs.
“There’s no substantive indication of effectiveness (in the military prevention programs) and most importantly, there’s no evidence of an enduring impact,” said panelist David Rudd, provost at the University of Memphis and an authority on suicide in the military.
The Pentagon issued a statement Thursday saying that it is reviewing the study’s findings, said Army Lt. Col. Catherine Wilkinson, a spokeswoman.
The Institute study, requested by the Pentagon, follows an earlier Institute of Medicine review released last year concluding that the Pentagon and Department of Veterans Affairs are struggling to keep pace with a growing number of mental health problems generated by the wars.
The scientists in the study released Thursday singled out for prominent criticism the largest and costliest program, the Army’s Comprehensive Soldier Fitness effort — since expanded and renamed Comprehensive Soldier and Family Fitness.
The program teaches soldiers and family members coping strategies such as keeping a positive or optimistic outlook on life or cultivating strong social relationships. Army leaders said it provides soldiers with the tools to become emotionally resilient.
The Army began the program in 2009 amid increasing cases of suicide and mental illness. It has cost $125 million to teach the coping skills to a million soldiers.
The scientific panel said there is little or no evidence the program prevents mental illness.
The Army quickly disputed the findings, saying that its own research shows that the program improves an individual soldier’s “level of overall fitness in areas of social, emotional, spiritual, family and physical strength.”
But the committee said the Army’s method for measuring the program’s effectiveness has never been subjected to peer review. While those measurements appear significant, they do not mean improved mental health, the scientists said.
“This committee does not find these results meaningful,” the report said.
The panel cited other internal Army studies that showed no preventive benefits for combat troops who had received the training compared with those who did not for conditions such as PTSD, anxiety, depression and substance abuse.
Rudd characterized the Army program “as not a particularly wise investment to spend those kinds of dollars on.”
Lt. Col. Justin Platt, an Army spokesman, said the program was redesigned in recent years and is not now intended as a way of preventing illnesses such as PTSD or depression.
When it was started in 2009, it was supposed to be a “long-term preventative health strategy.” New goals released last year are now more generally worded. One of them, for example, says the program should provide soldier and families with “self-awareness and psychological resources and skills to cope with adversity and thrive in their lives.”
Rudd said the panel acknowledged the difficulty of developing preventive programs during wartime. He said many of the efforts, including comprehensive soldier fitness, clearly may have made sense at the time.
But he said that adjustments should be made and unsuccessful programs abandoned.
“If we are going to invest these kinds of dollars, it should be in things that are demonstrated to be effective,” Rudd said.