Suchergebnisse

Introduction and Background -- Overview of the Literature -- Methods -- Background Characteristics of Radical Extremists -- Pathways to Radicalization -- Deradicalizing and Leaving Extremist Organizations -- Participant Perspectives on Mitigation Strategies -- Synthesis and Recommendations -- Appendix A: Literature Review Methods and Scope -- Appendix B: Interview Protocols.

In recent years, policymakers and members of the media have raised concerns regarding access to behavioral health care for service members and veterans of the U.S. military and their families. Particular concern has been raised regarding the availability and accessibility of care to individuals covered by the U.S. Department of Defense Military Health System and the Veterans Health Administration. In this study, researchers analyzed the National Study of Drug Use and Health to examine utilization of behavioral health care among current or former wives of service members and veterans who are covered by either TRICARE or CHAMP-VA. Three findings of interest emerged from the analysis. First, relative to the comparison group, military wives were more likely to receive behavioral health services, but this pattern was exclusively due to use of prescription psychiatric medications. No difference was found for specialty behavioral health treatment. Second, residing in rural areas was negatively associated with behavioral health care service use for both groups. Third, contrary to expectations, military wives who live more than 30 minutes from a military treatment facility were more likely than military wives who lived closer to receive prescription psychiatric mediations but not other types of behavioral health services.

As part of an exploration of ways to predict what determines the targets of suicide attacks, RAND conducted a proof-of-principle analysis of whether adding sociocultural, political, economic, and demographic factors would enhance the predictive ability of a methodology that focused on geospatial features. This test case focused on terrorist bombing incidents in Israel, but the findings indicate that the methodology merits further exploration

Introduction -- Methods -- Remote Versus Non-Remote Differences in Demographics and Behavioral Health Care Utilization -- Access to Direct Care for the Behavioral Health Cohort -- Quality of Behavioral Health Care: Initial Care -- Quality of Behavioral Health Care: Medication Management -- Quality of Behavioral Health Care: Transitions of Care -- Summary and Recommendations -- Appendix A: Sensitivity Analyses of Remoteness Definition -- Appendix B: Technical Specifications for Access and Behavioral Health Quality of Care Measures -- Appendix C: PTSD, Depression, and SUD Cohort Demographic and Service Characteristics -- Appendix D: Cohort Descriptive Data by Diagnostic Cohort -- Appendix E: Summary of Remote Versus Non-Remote Differences in Behavioral HealthQuality Measures.

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

With many service members now returning to the United States from the recent conflicts in Iraq and Afghanistan, concern over adequate access to behavioral health care (treatment for mental, behavioral, or addictive disorders) has risen. Yet data remain very sparse regarding how many service members (and their dependents) reside in locations remote from behavioral health providers, as well as the resulting effect on their access to and utilization of care. Little is also known about the effectiveness of existing policies and other efforts to improve access to services among this population. To help fill these gaps, a team of RAND researchers conducted a geospatial analysis using TRICARE and other data, finding that roughly 300,000 military service members and 1 million dependents are geographically distant from behavioral health care, and an analysis of claims data indicated that remoteness is associated with lower use of specialty behavioral health care. A review of existing policies and programs discovered guidelines for access to care, but no systematic monitoring of adherence to those guidelines, limiting their value. RAND researchers recommend implementing a geospatial data portal and monitoring system to track access to care in the military population and mark progress toward improvements in access to care. In addition, the RAND team highlighted two promising pathways for improving access to care among remote military populations: telehealth and collaborative care that integrates primary care with specialty behavioral care.