The Walter Reed Army Institute for Research has asked the American
Psychiatric Institute for Research and Education (APIRE) to develop clinically
detailed data on the extent to which the Army's military treatment facilities
and clinics provide mental health care to soldiers consistent with
evidence-based, best practices (see Independent Report Spotlights War's MH
The study will attempt to overcome the possible underreporting of diagnosis
and treatment of psychological problems by obtaining anonymized data from
clinicians, said Joyce West, Ph.D., M.P.P., director of APIRE's Psychiatric
Practice Research Network.
"We will review treatment consistency with evidenced-based guidelines
for PTSD and other conditions," West told Psychiatric News.
West is APIRE's principal investigator for this new study contract, which will
take about two years to complete.
The study will look at routine practice in Army behavioral health treatment
settings and will include patient, clinician, setting, and clinical
characteristics and determine the treated prevalence of PTSD. It will assess
how well clinical practice in Army behavioral health settings conforms to
evidence-based treatment guideline recommendations, especially how PTSD
treatment and other conditions (like substance abuse) are related to attrition
from military service.
The study will also examine the assessment and treatment of suicidal
ideation and behavior in routine practice and will look at mild traumatic
brain injury and relationship problems. Diagnostic practices will be reviewed
to identify the accuracy of mental illness diagnostic codes uses in the
military medical services.
Finally, the study will lay the groundwork for future research into
practice patterns by testing methodology used to regularly collect basic
practice-level data in Army behavioral health treatment settings.
Also, APIRE research scientist Farifteh Duffy, Ph.D. will serve as the
principal investigator of a recently funded Department of Defense
Post-Traumatic Stress Disorder Research Program Concept Award, designed"
to spark new ideas, innovative technologies, and ground-breaking
concepts that will drive the field of PTSD research forward."
The APIRE study will systematically identify and disseminate key
evidence-based recommendations to support clinical decision making to mental
health clinicians treating soldiers and veterans with PTSD. A concentrated
continuing medical education curriculum will be developed, modeled after the
Institute for HealthCare Improvement Break-through Series, and derived from
current evidence-based practice guidelines for PTSD to prepare clinicians in
evidence-based screening, diagnosis, and treatment of PTSD. ▪