Department of Defense (DoD) strives to use evidence-based treatments for mental health disorders and other conditions through the use of clinical practice guidelines (CPGs) and clinical support tools. This section contains the CPGs for mental health disorders and select conditions, as well as their corresponding clinical support tools; ethical considerations for mental health providers; and information regarding the disclosure of protected health information in the military.
Clinical Practice Guidelines
The Institute of Medicine defines CPGs as: "…systematically developed statements to assist practitioner and patient decisions about appropriate health care services for specific clinical circumstances." DoD has made it a priority to implement evidence-based CPGs as a means of improving and standardizing the quality of care provided to its beneficiaries. Since 1988, VA and DoD have worked together to adapt internationally recognized CPGs to meet the requirements of the military and veterans’ health care systems.
The VA/DoD Evidence-based Practice Working Group, which includes multi-disciplinary representatives from DoD, Army, Navy, Air Force and the Veterans Health Administration (VHA), creates and updates guidelines based on readiness needs of the military as well as the high-volume, high-cost health conditions treated in the medical treatment facilities. The working group also develops supporting materials, including tool kits and metrics, to assist providers in implementing the CPGs. Guidelines are available for: chronic disease in primary care, mental health, military-related, pain, rehabilitation and women’s health. Treatment guidance for mental health disorders across the military is directed by evidence-based practices whenever possible.
In addition to this website, the VA/DoD clinical practice guidelines can also be found on the VA clinical practice guidelines website and the U.S. Army Medical Command Quality Management Office website.
Clinical Support Tools
DCoE, in partnership with the VA, has created clinical support tools as supplemental materials to promote compliance with the clinical practice guidelines. These tools bring together important resources for providers, patients and family members that support comprehensive, evidence-based treatment across the VA and DoD.
Pharmacological Treatment Guidance
Treatment guidance for pharmacological therapy is provided by DoD Pharmacy Operations Division (POD), a “a customer-oriented Center of Excellence implementing recognized state-of-the-art pharmacoeconomic analysis for the purpose of improving readiness by increasing value, quality, and access to medical care and pharmacotherapy within the available resources of the Military Health System (MHS).” The POD’s actions include:
- Monitor drug usage and cost trends and performs pharmacoeconomic analyses to support DoD formulary management, national pharmaceutical contracts, and clinical practice guidelines.
- Provide administrative and technical support for the DoD Pharmacy & Therapeutics Committee, which manages the DoD Basic Core Formulary (BCF) and the TRICARE Uniform Formulary.
- The Pharmacy Analytics Support Section supports users of the Pharmacy Data Transaction Service, a centralized prescription data repository that provides a single, comprehensive patient drug profile for DoD beneficiaries across the MHS.
- Help in the development and management of information systems that support the provision of drug therapy and evaluation of the pharmacy benefit.
- Work with the Defense Logistics Agency & the VA Pharmacy Benefits Management Strategic Health Group and National Acquisition Center to establish national pharmaceutical contracts.
- Work with the VA/DoD Clinical Practice Guideline Workgroup to formulate the drug therapy components of clinical practice guidelines and associated metrics.