Interagency Strategic Drivers

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The DoD engages in significant inter-agency collaboration which drives the priorities and strategy of the MHS. With regards to mental health, there are several notable inter-agency collaborative efforts including the Integrated Mental Health Strategy (IMHS), the Interagency Task Force on Military and Veterans Mental Health (ITF), and the Cross-Agency Priority Goal (CAPG) on Service Members and Veterans Mental Health.

Integrated Mental Health Strategy

In 2002, Congress mandated the creation of the Joint Executive Committee (JEC) for DoD and VA to collaborate and improve the care and services offered to service members and veterans. Under the JEC, the Health Executive Committee (HEC) was established to manage health-related initiatives across the agencies. One of the working groups chartered under the HEC, Psychological Health/Traumatic Brain Injury (PH/TBI) Working Group, manages recommendations as noted in the JEC Joint Strategic Plan regarding psychological health and TBI, specifically. In 2009, to further coordinate efforts, DoD and VA held a cross-agency summit on mental health. In 2010, the Senior Oversight Committee requested the development of a joint mental health strategy from which emerged the IMHS aimed at addressing 28 initiatives using a coordinated public health model to improve access, quality, effectiveness and efficiency of mental health services across DoD and VA.

The four strategic goals of the strategy include:

  1. Expand access to behavioral health care in DoD and VA
  2. Ensure quality and continuity of care across the departments for service members, veterans, and their families
  3. Advance care through community partnership, education and successful public communication
  4. Promote resilience and build better behavioral health care systems for tomorrow

The HEC PH/TBI Working Group convened to develop actionable solutions for these initiatives including:

  • Integration of mental health services into primary care
  • Expansion of eligibility of Vet Center readjustment counseling services to service members, as well as service members and veterans in rural areas
  • Mechanisms for sharing mental health care personnel between departments to meet urgent needs
  • Recommended quality measures for mental health services and evaluating patient outcomes
  • Dissemination of knowledge of suicide risk and prevention strategies
  • Mechanisms for reviewing activities of outside organizations and developing collaborations or partnerships
  • Approaches to promote utilization of self-help strategies for mental health concerns through web services, print material and seminars and facilitating access to these web-based resources
  • The role of chaplains in mental health care

Interagency Task Force on Military and Veterans Mental Health

In 2012, the president issued Executive Order 13625- Improving Access to Mental Health Services for Veterans, Service Members, and Military Families which emphasized the need for mental health services, research and partnerships across several departments including DoD, VA, and  HHS.

Section six of this order, established the ITF with the aim of:

  • Strengthening suicide prevention efforts across DoD and veteran communities
  • Enhancing access to mental health care by building partnerships between the VA and community providers
  • Increasing the number of VA mental health providers serving our veterans
  • Promoting mental health research and development of more effective treatment methodologies (through the National Research Action Plan (NRAP)[1] (more information can be found in the Research section).

The ITF, co-chaired by the secretaries of DoD, VA, and HHS, includes members from several agencies: VA, DoD, HHS, Domestic Policy Council, National Security Council, Office of National Drug Control Policy, Department of Education, Office of Management and Budget, and the Office of Science and Technology Policy.

In August 2014, the president announced 19 new executive actions to build on the 2012 executive order requirements and previous recommendations. These efforts include:

  • Improving service members’ transition from DoD to VA and civilian health care providers
    • Supporting service members with mental health conditions in making the transition to VA care
    • Ensuring continuity of mental health medications during the transition from DoD to VA
    • Coordinating care between DoD and VA
  • Improving access and quality of mental health care at DoD and VA
    • Integrating peer specialists into primary care
    • Supporting TRICARE mental health parity
    • Enhancing mental health care where service members work
  • Continuing our commitment to improve treatments for mental health conditions including PTSD
    • Harnessing the efforts of researchers from DoD, VA, and the National Institutes of Health and academia
    • Advancing cutting edge PTSD research
    • Early detection of suicidality and PTSD
    • New investments in suicide prevention
  • Raising awareness about mental health and encouraging individuals to seek help
    • Promoting Vet Centers as a counseling resource for combat veterans and their families
    • Training DoD and VA employees to recognize the signs and symptoms of mental health conditions and help connect people in need to help
    • Expanding mental health awareness campaigns
    • Providing mental health awareness training more broadly
  • Improving patient safety and suicide prevention
    • Expanding access to opiate overdose reversal kits
    • Providing new opportunities for service members, veterans and their families to give back unwanted medications
    • Supporting suicide prevention
  • Strengthening community resources for service members, veterans and their families
    • Expanding cultural competency training
    • Supporting construction of medical facilities in communities with large veteran populations

Cross-Agency Priority Goal

The latest progress on this CAPG and related initiatives is posted quarterly on the Performance.gov website.

In March 2014, the ITF also began executing the newly-established CAPG on Service Members and Veterans Mental Health, overseen by the Executive Office of the President. The president initiated the CAPGs to accelerate the progress of a small number of priority areas by enhancing collaboration across agencies and encouraging accountability. This CAPG with the goal to “improve mental health outcomes for service members, veterans and their families” is one of 15 priority areas with the vision “to identify and build on effective programs and initiatives that reduce barriers to seeking care, enhancing access and improving the quality of mental health care, and to support innovative research on mental health and substance use care and treatment for service members, veterans and their families.”

References

[1] National Research Action Plan (NRAP).