Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.

For the first time, a single reference identifies medical technology assessment programs. A valuable guide to the field, this directory contains more than 60 profiles of programs that conduct and report on medical technology assessments. Each profile includes a listing of report citations for that program, and all the reports are indexed under major subject headings. Also included is a cross-listing of technology assessment report citations arranged by type of technology headings, brief descriptions of approximately 70 information sources of potential interest to technology assessors, and addresses and descriptions of 70 organizations with memberships, activities, publications, and other functions relevant to the medical technology assessment community.

The challenges facing military veterans who return to civilian life in the United States are persistent and well documented. But for all the political outcry and attempts to improve military members' readjustments, veterans of all service eras face formidable obstacles related to mental health, substance abuse, employment, and — most damningly — homelessness. Homelessness Among U.S. Veterans synthesizes the new glut of research on veteran homelessness — geographic trends, root causes, effective and ineffective interventions to mitigate it — in a format that provides a needed reference as this public health fight continues to be fought. Codifying the data and research from the U.S. Department of Veterans Affairs (VA) campaign to end veteran homelessness, psychologist Jack Tsai links disparate lines of research to produce an advanced and elegant resource on a defining social issue of our time.

For many of the 1.6 million U.S. service members who have served in Iraq and Afghanistan since 2001, the trip home is only the beginning of a longer journey. Many undergo an awkward period of readjustment to civilian life after long deployments. Some veterans may find themselves drinking too much, unable to sleep or waking from unspeakable dreams, lashing out at friends and loved ones. Over time, some will struggle so profoundly that they eventually are diagnosed with post-traumatic stress Disorder (PTSD). Both heartbreaking and hopeful, Fields of Combat tells the story of how American veterans and their families navigate the return home. Following a group of veterans and their their personal stories of war, trauma, and recovery, Erin P. Finley illustrates the devastating impact PTSD can have on veterans and their families. Finley sensitively explores issues of substance abuse, failed relationships, domestic violence, and even suicide and also challenges popular ideas of PTSD as incurable and permanently debilitating. Drawing on rich, often searing ethnographic material, Finley examines the cultural, political, and historical influences that shape individual experiences of PTSD and how its sufferers are perceived by the military, medical personnel, and society at large. Despite widespread media coverage and public controversy over the military's response to wounded and traumatized service members, debate continues over how best to provide treatment and compensation for service-related disabilities. Meanwhile, new and highly effective treatments are revolutionizing how the Department of Veterans Affairs (VA) provides trauma care, redefining the way PTSD itself is understood in the process. Carefully and compassionately untangling each of these conflicts, Fields of Combat reveals the very real implications they have for veterans living with PTSD and offers recommendations to improve how we care for this vulnerable but resilient population.

U.S. military conflicts abroad have left nine million Americans dependent on the Veterans Health Administration (VHA) for medical care. Their "wounds of war" are treated by the largest hospital system in the country—one that has come under fire from critics in the White House, on Capitol Hill, and in the nation's media. In Wounds of War, Suzanne Gordon draws on five years of observational research to describe how the VHA does a better job than private sector institutions offering primary and geriatric care, mental health and home care services, and support for patients nearing the end of life. In the unusual culture of solidarity between patients and providers that the VHA has fostered, Gordon finds a working model for higher-quality health care and a much-needed alternative to the practice of for-profit medicine.

High-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels. Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country's primary care services a public concern. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care puts forth an evidence-based plan with actionable objectives and recommendations for implementing high-quality primary care in the United States. The implementation plan of this report balances national needs for scalable solutions while allowing for adaptations to meet local needs.

Veterans Justice Outreach Program: VA Could Improve Management by Establishing Performance Measures and Fully Assessing Risks