APNewsBreak: Study: PTSD programs duplicated

By DAN ELLIOTT | November 14, 2011 | 6:55 PM EST

DENVER (AP) — The U.S. military has more than 200 programs devoted to brain injuries and the psychological health of its men and women, but no uniform way to evaluate whether they work or to share their findings, according to a study commissioned by the Pentagon.

The Rand Corp. study said some programs overlap and the proliferation of programs creates "a high risk of a poor investment" of military spending.

Military officials are still reviewing the report, but some of its recommendations are already being implemented, Defense Department spokeswoman Cynthia O. Smith said Monday.

The proliferation of programs came about because each branch of the service has the authority to create its own programs and because local commanders can also create or adapt programs to fit needs, Smith said in an email to The Associated Press.

The Defense Department estimates that nearly 213,000 U.S. military personnel have suffered traumatic brain injuries in Iraq and Afghanistan since 2000. An earlier Rand report estimated that 300,000 veterans of those wars suffered post-traumatic stress disorder or major depression.

The new study released last week identified 211 military programs designed to prevent, identify and treat brain injuries and psychological problems such as PTSD.

The programs range from offerings at individual military bases for a single issue, such as PTSD, to programs used across the services to address multiple problems including suicide, domestic violence, stress reduction and other areas.

Researchers in some military programs didn't know whether anyone else in the military had similar programs or whether those programs had worked, the study said. It recommended a centralized way to collect findings that are readily available.

"Nobody should have to start from scratch again," Robin Weinick, one of the Rand study authors, said in an interview.

The study also recommended that the Pentagon find a systematic way to evaluate which programs work. Only a tenth to a third of the programs targeting any branch of the military had been evaluated in the previous 12 months for effectiveness, the study said.

Researchers said few of the 211 programs had a working relationship with the military care system or a formal way of referring personnel or their families to clinics for care. The study also said the specific roles and possible contributions of some individual programs weren't clear.

Military leaders know little about how the programs mesh, said Smith, the Defense Department spokeswoman.

"Even less is known about the effectiveness of these efforts due to a lack of data needed to evaluate the individual programs," she wrote in her email.

Smith said the military asked Rand to take a snapshot of programs sponsored or funded by the Defense Department that deal with psychological health and traumatic brain injury.

She said this report is the first of three expected from a $7 million study. Future reports will look at ways to evaluate programs and the effectiveness of some programs.

Cost estimates for all the programs combined were not available, Smith said.

Weinick and Rand researcher Carrie Farmer said the Pentagon's attention to the problems underscores its commitment to address the issues.

But they said the study shows the Pentagon should do a comprehensive survey of what servicemen and women need and come up with a coordinated way to collect and share findings from the scores of programs under way.

Just tracking down the programs was a huge chore because the Defense Department itself had no central list or clearinghouse, Weinick said.

Researchers spoke to more than 800 people and searched the Internet, media reports and paper documents to compile their list.

"'Daunting' is most certainly a fair way to put it," Weinick said.


Online: The Rand study is at http://www.rand.org/pubs/research_briefs/RB9606.html


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