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News and Notes   |    
News and Notes
Psychiatric Services 2014; doi: 10.1176/appi.ps.658news
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Copyright © 2014 by the American Psychiatric Association

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Final IOM report on DoD and VA programs for PTSD: In 2010, Congress directed the Department of Defense (DoD) and the Department of Veterans Affairs (VA) to assess prevention and treatment programs for posttraumatic stress disorder (PTSD) offered to military and veteran populations. Recently released by the Institute of Medicine (IOM), the 284-page assessment notes that both DoD and VA “have made a sustained commitment to PTSD management and invested substantial financial and programmatic resources to provide care to service members and veterans. However, a lack of standards, reporting, and evaluation significantly compromises these efforts. The departments often do not know what treatments patients receive or whether treatments are evidence based, delivered by trained providers, cost-effective, or successful in improving PTSD symptoms.” The need for centralized oversight is a critical issue described in the report. Although some programs are under the authority of the DoD central office, others are dispersed across service branches and installation and medical commands. In VA, policy and oversight are managed by the central office, but regional and local authorities have responsibility for operations and service innovations. Neither DoD nor VA has a mechanism for the systematic collection, analysis, and dissemination of outcome and cost data for assessing the quality of PTSD care. As the report notes, both DoD and VA have expanded their mental health workforce to broaden access, often by use of “purchased care providers.” However, the report raised questions about these providers’ adherence to VA/DoD PTSD practice guidelines. The report ends with eight recommendations, including mandating use of best and evidence-based practices, implementing a measurement-based PTSD management system, and establishing a central database of programs and services. The report is available on the IOM Web site at www.iom.edu/reports.

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