DoD promotes the use of empirically supported screening and assessment procedures. Screening identifies those who exhibit symptoms of posttraumatic stress disorder (PTSD) and determines who should receive full evaluation from a trained mental health care provider.
- DoDI 6490.15 Integration of Behavioral Health Personnel Services into Patient-Centered Medical Home (PCMH) Primary Care and Other Primary Care Service Settings notes mandated screening for PTSD annually, for all new patients, and if clinically indicated.
- Military Treatment Facility Mental Health Clinical Outcomes Guidance provides guidance for measurement and documentation of clinical outcomes, to include use of the PC-PTSD and the PCL for PTSD screening.
Screening for PTSD in Primary Care
The DoD patient-centered medical home (PCMH) initiative includes mandatory annual screening for PTSD (among other mental health conditions) for all beneficiaries of the Military Health System. Primary care offers an ideal setting to educate patients and their families about PTSD and treatment options. Screening for PTSD in primary care may include the Primary Care-PTSD Screen (PC-PTSD), followed by the PTSD Checklist (PCL) if the PC-PTSD is positive. These measures can assess treatment progress or changes to clinical presentation with repeated administrations.
PTSD Screening Tools
Primary Care-PTSD Screen (PC-PTSD) The PC-PTSD is a six-item (yes/no) screening measure for use in primary care and other medical settings. Patients screen positive if they answer “yes” to three or more items and should receive further evaluation for PTSD.
PTSD Checklist for DSM-5 (PCL-5) The PCL-5 is a 20-item self-report tool using a 0-4 Likert scale, appropriate for use in screening individuals for PTSD, making a provisional PTSD diagnosis and monitoring PTSD symptom change during and after treatment. It aligns with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for PTSD. There are three formats: (1) includes criterion A component (stressor); (2) without a criterion A component; (3) extended criterion A component along with the Life Events Checklist for the DSM-5 (LEC-5).