The next is the June 2025, Authorities Accountability Workplace report, Army to Civilian Transition: Actions Wanted Guarantee Efficient Psychological Well being Screening at Separation.
From the report
What GAO Discovered
Federal legislation and Division of Protection (DOD) coverage require well being exams for service members separating from energetic responsibility. DOD administers most exams for these service members. The Division of Veterans Affairs (VA) administers these exams for service members submitting for incapacity advantages at separation, resembling these with an sickness or damage brought on by army service. To assist coordinate efforts, VA and DOD developed a joint separation well being evaluation with psychological well being screens not included in DOD’s current separation examination. VA applied the joint evaluation in April 2023. As of Could 2025, DOD had not applied the joint evaluation however had accomplished a pilot of it at three websites.
The joint evaluation contains 5 psychological well being screens for 1) melancholy, 2) suicide danger, 3) alcohol use, 4) post-traumatic stress dysfunction (PTSD), and 5) violence danger. GAO discovered that two of those psychological well being screens are validated instruments. Which means that they’ve been examined and decided to be each efficient at figuring out people in danger for a particular situation and dependable at yielding constant outcomes if administered to the identical particular person greater than as soon as. Two of the opposite psychological well being screens are primarily based on validated instruments, however VA and DOD modified the screens with out validating the adjustments.
The remaining joint evaluation display screen for violence danger isn’t primarily based on a validated device. It was included for consistency with different DOD well being evaluation varieties, in accordance with officers. Analysis reveals that violence screening could also be helpful for service members, however a number of subject material specialists GAO interviewed expressed considerations in regards to the violence danger display screen’s effectiveness.
Analysis reveals that with out validation testing, VA and DOD can’t be positive in regards to the effectiveness or reliability of the screening they’re conducting for alcohol use, PTSD, and violence danger. Utilizing validated psychological well being screens would offer VA and DOD with larger assurance that their efforts to establish service members needing psychological well being help at separation are efficient.
VA information present its contractors administered about 50,500 joint separation well being assessments between Could 2023 and April 2024 to service members being evaluated for incapacity advantages. Of these exams, about 67 % of service members had at the very least one constructive psychological well being display screen. A constructive display screen signifies elevated danger for the precise psychological well being situation being assessed and might point out a necessity for additional analysis or intervention.
GAO discovered that VA’s commonest constructive psychological well being screens on the joint evaluation have been for PTSD and melancholy. VA and DOD officers famous that total, the joint evaluation screening charges are larger than can be anticipated in a scientific setting or primarily based on inhabitants prevalence for these issues. Within the case of screening for alcohol use and PTSD, VA and DOD modifications to those instruments could have contributed to larger constructive screening charges. Moreover, DOD officers mentioned that many components may improve the potential for constructive psychological well being screens amongst separating service members, together with that this subgroup of service members intends to file incapacity claims.
Clinicians administering the joint assessments are required to make sure that service members who display screen constructive are conscious of obtainable psychological well being care choices and supply them a referral to DOD’s inTransition program, which is to supply help with psychological well being companies throughout transitions. GAO’s evaluation of VA’s joint evaluation information discovered that 48 % of service members who have been provided an inTransition referral accepted, and 52 % declined. VA doesn’t monitor service members’ causes for declining these referrals. Nevertheless, VA officers famous that some service members would possibly decline the referral if they’re already concerned in psychological well being therapy.
Moreover, when service members display screen constructive for suicide danger on the joint evaluation, clinicians are to evaluate their stage of danger and take particular actions primarily based on that dedication. For instance, clinicians are required to contact the Veterans Disaster Line for high-risk people, amongst different actions.
Why GAO Did This Examine
Hundreds of service members separate from the army annually, and analysis has proven that they’re particularly susceptible throughout this transition to civilian life. A 2018 govt order directed VA and DOD to develop a joint motion plan to make sure entry to psychological well being care and suicide prevention companies for separating service members. The ensuing plan referred to as for psychological well being screenings of all service members previous to separation, amongst different initiatives.
The Home report accompanying the Nationwide Protection Authorization Act for Fiscal Yr 2024 features a provision for GAO to evaluate VA and DOD’s implementation of psychological well being exams for service members transitioning out of the army. Amongst different subjects, this report examines the extent to which VA and DOD primarily based the joint separation well being evaluation’s psychological well being screening questions on validated screening instruments and the outcomes of VA’s psychological well being screening utilizing the joint evaluation.
To handle these targets, GAO reviewed chosen scientific research to find out the effectiveness and reliability of the joint evaluation’s particular psychological well being screens. GAO additionally reviewed validated screening device suggestions in related scientific follow tips issued by organizations together with VA and DOD. GAO interviewed VA and DOD officers, in addition to psychological well being subject material specialists recognized by skilled associations such because the American Psychiatric Affiliation.
GAO reviewed obtainable psychological well being screening information from joint separation well being assessments accomplished by VA contractors between Could 2023—the month following its implementation— and April 2024. GAO additionally reviewed VA steering for administering the joint assessments, together with the method to be adopted when a service member screens constructive for psychological well being considerations, together with their danger for suicide. Lastly, GAO interviewed VA officers and representatives of the three contractors that administer the joint assessments about what steps they take if somebody screens constructive on the psychological well being screening questions.
What GAO Recommends
GAO is making a complete of three suggestions to the VA-DOD Joint Govt Committee that developed the joint separation well being evaluation to (1) be sure that the joint evaluation’s alcohol use display screen is validated, (2) be sure that the joint evaluation’s PTSD display screen is validated, and (3) assess whether or not to incorporate violence danger screening within the joint evaluation and take acceptable follow-up motion. Attainable actions may embody taking steps to validate the joint evaluation’s current violence danger questions, changing them with a special validated device, or eradicating the questions, as acceptable.
VA concurred with GAO’s suggestions whereas DOD partially concurred with them. DOD acknowledged that the VA-DOD Joint Govt Committee ought to discover utilizing validated screens however didn’t commit to making sure that the alcohol use, PTSD, and violence danger screens are validated. GAO maintains its suggestions are warranted and that any screening device used within the joint evaluation be validated.
Obtain the doc right here.
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