Lisa S. Meredith

This book summarizes key findings and recommendations from "Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery" (Tanielian and Jaycox [Eds.], MG-720-CCF, 2008), a comprehensive study of the post-deployment health-related needs associated with post-traumatic stress disorder, major depression, and traumatic brain injury among veterans of Operations Enduring Freedom/Iraqi Freedom.

To support development of Puerto Rico's short- and long-term recovery and resilience plan, experts conducted a comprehensive assessment of the commonwealth's challenges and the damage caused by the 2017 hurricanes. They identified short- and longer-term needs for Puerto Rico to recover and to build resilience to future storms; economic, social, and environmental trends; and ongoing governance challenges. This report summarizes their work.

This report uses a review of organizational culture literature to help address the U.S. Army's organizational challenges, such as behavioral health treatment stigma, negative workplace behaviors, and participation of women in combat. Researchers identified key drivers of cultural change, and a group of subject matter experts analyzed the results of the literature review by identifying the most important drivers of cultural change for the Army.

Welcome Back Veterans (WBV) supports organizations that, in turn, provide programs and services to support veterans and their families. WBV has made strides in assisting service members, veterans, and families and in facilitating collaboration among systems of care in local communities. However, strategic efforts are needed to promote sustainability and address emerging challenges as these programs integrate with other systems of care.

As U.S. service members deploy for extended periods on a repeated basis, their ability to cope with the stress of deployment may be challenged. Many programs are available to encourage and support psychological resilience among service members and families. However, little is known about these programs' effectiveness. This report reviews resilience literature and programs to identify evidence-informed factors for promoting resilience.

Presents detailed findings, based on surveys and interviews with stakeholders, on the TRICARE demonstration of its impact on health care utilization, cost, and outcomes of health care services Federal legislation in 2001 required the Department of Defense to conduct a demonstration involving expanded access under TRICARE to licensed or certified mental health counselors. The authors present detailed findings, based on surveys and interviews with stakeholders, on the impact on health care utilization, cost, and outcomes. The authors examine and compare pre-demonstration and post-demonstration data, and they compare results of military catchment areas that participated in the demonstration and control catchment areas.

One of the major concerns about the changing U.S. health-care systems is whether they will improve or diminish the quality and cost-effectiveness of medical care. The shift from a fee-for-service to a prepaid method of reimbursement has greatly changed the incentives of patients to seek care as well as those of providers to supply it. This change poses a particular challenge for care of depressed patients, a vulnerable population that often does not advocate for its own care. This book documents the inefficiencies of our national systems--prepaid as well as fee-for-service--for treating depression and explores how they can be improved.Although depression is a major illness affecting millions of people, it is seriously undertreated in the United States. The ongoing shift of mental-health care away from specialists and toward primary medical-care providers is causing fewer depressed patients to be appropriately diagnosed and treated. Depression is frequently more devastating than other major illnesses, such as arthritis and heart disease, because it often begins at a younger age, when people are at their productive peak and thus at risk of permanently damaging their careers. It also differs from many medical conditions in that its indirect costs are usually much higher than direct treatment costs.The authors urge the integration of both medical and economic considerations in designing policies for the treatment of depression. They show that by spending more money efficiently on care, the nation will gain greater health improvements per dollar invested and a more productive population.