A review of the scientific evidence on suicide postvention (organizational responses to prevent additional suicides and help loss survivors cope), guidance for other types of organizations, and the perspectives of the family and friends of service members who have died by suicide provide insights that may help the U.S. Department of Defense formulate its own policies and programs in a practical and efficient way.

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.

Most leaders in the Department of Defense (DoD) agree that family resilience is an important construct, yet DoD does not have a standard definition. The authors of this report review existing definitions of family resilience and offer a candidate definition for DoD use. They also review models of family resilience, identify key family resilience factors, and make recommendations for how DoD can manage family-resilience programs and policies.

This report presents results from a systematic review and meta-analyses of research examining how mindfulness meditation affects 13 performance-related outcomes of interest to the U.S. Army and broader military. The authors supplemented the systematic review by examining how mindfulness meditation could support stress management and exploring characteristics of selected mindfulness programs.

Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT-2) is a manualized group cognitive behavioral therapy program for co-occurring depression and alcohol and drug use problems. BRIGHT-2 has been designed so that non0́3mental health practitioners, and practitioners with less formal training than professional mental health counselors, can deliver the program, thus providing evidence-based depression treatment to individuals who often do not receive it. BRIGHT-2 is an 18-week program consisting of three modules, each of which focuses on a specific topic0́4thoughts, activities, and people interactions0́4and how it can affect a person0́9s mood and desire to drink or use drugs. The BRIGHT-2 manual consists of a leader0́9s introduction, a session-by-session group leader manual, and a session-by-session group member0́9s workbook; this volume is the group member0́9s workbook.

Behavioral health disparities, in which socially disadvantaged groups such as racial/ethnic minorities, women, and sexual orientation minorities experience greater risk for certain mental health and substance use problems, are well documented in the general population. Less is known about whether similar behavioral health disparities exist among military service members. The U.S. Department of Defense (DoD) wanted to understand whether the behavioral health disparities seen in the civilian population also exist in the military, which is important to help DoD target its efforts to address the needs of service members and improve force readiness. To investigate this issue, RAND researchers examined the following: (1) whether minority group service members are more likely to experience mental health and substance use problems relative to their majority counterparts in the military and (2) whether minority-majority group differences in behavioral health within the military are similar or different from those in the civilian population. Any minority-majority group differences observed in the military were tested to see if they remain after accounting for sociocultural environmental factors (e.g., demographics, social support, harassment). Identifying where behavioral health disparities exist among military minority service groups and the factors that may be associated with observed disparities can help DoD better target efforts to address the behavioral health needs of its troops. Further, if minority group disparities are greater in the military than in the civilian population, this might signal the presence of factors specific to the military context that may exacerbate minority group service members' risk for behavioral health conditions. The study used data from the 2015 Health Related Behavior Survey (HRBS), the 2015 National Survey on Drug Use and Health (NSDUH), the 2015 and 2016 Behavioral Risk Factor Surveillance System (BRFSS), and the 2015 National Health and Nutrition Examination Survey (NHANES). Behavioral health conditions included mental health (i.e., depression, suicide behaviors, posttraumatic stress disorder) and substance use (i.e., problematic alcohol use, tobacco use) outcomes.

The authors review data on the prevalence of youth mental health disorders and schools0́9 use of student mental health (SMH) programs. They also describe the role of schools in addressing SMH concerns and outline a conceptual model for guiding evaluation of SMH programs. Finally, they touch on issues related to evaluation of cross-system collaborations that can influence students0́9 access to resources and services and then review some of the challenges associated with evaluating SMH programs. They determine that SMH programs can be effective and can improve staff, faculty, and student knowledge of mental health problems; provide skills for identifying and referring students with mental health and social and emotional difficulties; and change attitudes toward mental health problems.