Report questions programs to fight psychological problems

Many federal programs aimed at preventing psychological problems for military service members and their families have not been evaluated correctly to determine whether they are working or supported by science, says a new report commissioned by the Defense Department.

“A lot of their programs don’t have any good data behind them,” said Kenneth Warner, a professor of public health at the University of Michigan, who led the Institute of Medicine committee that produced the report.

“We remain uncertain about which approaches work and which ones are ineffective.”

The report was especially critical of the Pentagon’s biggest and costliest prevention program, known as Comprehensive Soldier and Family Fitness, which is used throughout the Army.

Based on the principles of positive psychology, it includes training in assertiveness, negotiation and coping strategies such as maintaining an optimistic outlook on life. About 900,000soldiers receive the training each year at a cost of $ 50 million.

The Army has portrayed it as a success based on internal reviews that found soldiers saws mall improvements on some measures of psychological health.

But the medical committee concluded the program did not reduce rates of post- traumatic stress disorder or depression.

An Army spokesman, Lt. Col. S. Justin Platt, said the program was not designed to prevent PTSD and depression but to improve social, emotional, spiritual, family and physical wellbeing. He said the Army stood by its conclusions and that military families found the training effective.

More than 90 prevention programs are scattered throughout the military. Experts said the total cost could easily top $ 1 billion.

The Institute of Medicine, the health arm of the National Academies, reviewed a broad sample of those programs.

The committee was unable to find any evidencebased programs to prevent domestic abuse in military families. And though sexual assault in the military is getting more attention, the military has no way to measure whether its prevention programs are working, the study concluded.

At the same time, some proven interventions are not being used, the committee found. Researchers said limiting access to personal firearms on military bases could reduce suicides.