To help the U.S. Department of Defense (DoD) estimate the percentage of service members who experienced racial or ethnic harassment or discrimination in the past year, RAND Corporation researchers, with feedback from external experts and DoD representatives, developed a survey instrument. The authors of this report describe the instrument-development process, the instrument itself, and recommendations to support its use.

This paper reviews data on the prevalence of sexual assault among servicemembers, predictors of disclosure, efforts to improve disclosure, victim needs and DoD efforts to provide necessary resources in the immediate aftermath of a sexual assault. The authors compared civilian and DoD guidelines for care and found them to be generally consistent. However, little is known about the fidelity with which DoD recommendations are implemented.

To inform improvements to the quality of care delivered by the military health system for posttraumatic stress disorder and major depressive disorder, researchers developed a framework and identified, developed, and described a candidate set of measures for monitoring, assessing, and improving the quality of care. This document describes their research approach and the measure sets that they identified.

Concerns about access to behavioral health care for military service members and their dependents living in geographically remote locations prompted research into how many in this population are remote and the effects of this distance on their use of behavioral health care. The authors conducted geospatial and longitudinal analyses to answer these questions and reviewed current policies and programs to determine barriers and possible solutions.

This report describes analyses, using data from the 2014 RAND Military Workplace Study, designed to identify how the sexual harassment of others in a service member's work environment affects his or her own risk of being sexually assaulted.

The National Intrepid Center of Excellence (NICoE) provides specialized services for troops suffering from traumatic brain injury (TBI). RAND evaluated interactions between the NICoE and providers referring patients and implementing treatment plans.

Ensuring that military veterans and their families have access to high-quality mental health care is a national priority. Over the past several years, the Departments of Defense and Veterans Affairs have increased the number of mental health professionals working within their facilities and have rolled out training and quality improvement initiatives designed to promote the use of evidence-based treatments. Despite these important efforts, research continues to demonstrate that many veterans prefer to seek services outside the Department of Defense and/or the Department of Veterans Affairs. Thus, providers working in the civilian sector are an increasingly important part of the overall workforce addressing veterans' mental health needs. To better understand a key aspect of our nation's ability to provide veterans and their families with access to high-quality mental health care, RAND conducted a survey of civilian mental health providers to gather information about their competency with military and veteran culture and their training and experience treating posttraumatic stress disorder and depression. This report provides the results of that survey. The findings and recommendations from this study should be relevant to individuals, organizations, and policy officials concerned about the capacity of the civilian health care sector to deliver culturally competent, high-quality services to veterans and their families.

Providing accessible, high-quality care for psychological health (PH) conditions, such as posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), is important to maintaining a healthy, mission-ready force. It is unclear whether the current system of care meets the needs of service members with PTSD or MDD, and little is known about the barriers to delivering guideline-concordant care. RAND used existing provider workforce data, a provider survey, and key informant interviews to (1) provide an overview of the PH workforce at military treatment facilities (MTFs), (2) examine the extent to which care for PTSD and MDD in military treatment facilities is consistent with Department of Veterans Affairs/Department of Defense clinical practice guidelines, and (3) identify facilitators and barriers to providing this care. This report provides a comprehensive assessment of providers' perspectives on their capacity to deliver PH care within MTFs and presents detailed results by provider type and service branch. Findings suggest that most providers report using guideline-concordant psychotherapies, but use varied by provider type. The majority of providers reported receiving at least minimal training and supervision in at least one recommended psychotherapy for PTSD and for MDD. Still, more than one-quarter of providers reported that limits on travel and lack of protected time in their schedule affected their ability to access additional professional training. Finally, most providers reported routinely screening patients for PTSD and MDD with a validated screening instrument, but fewer providers reported using a validated screening instrument to monitor treatment progress.--

"Pressures inside and outside the U.S. Department of Defense (DoD) to reduce the incidence of problematic behaviors within the military are inducing the Office of the Secretary of Defense to rethink how it is organized to oversee and coordinate DoD's varied behavior-mitigation efforts. This report provides the results of a RAND study that examined the integration of programs for addressing a specified set of problematic behaviors: sexual harassment, sexual assault, unlawful discrimination, substance abuse, suicide, and hazing. The report combines the results of the two major lines of research: the first related to the development of a typology of common problematic behavior risk and protective factors and prevention methods based on a review of the behavioral science literature, and the second related to the organization, coordination, oversight, and managerial practices of programs to address problematic behavior based on document analysis and policy discussions with DoD and service headquarters officials. Following a discussion of findings from the two lines of research, the report lays out a series of recommendations for the Office of the Secretary of Defense to improve its understanding of the interrelationships among problematic behaviors and its oversight and coordination of programs to address those behaviors"--Publisher's description.