Post-Traumatic Stress Disorder Treatment Outcomes in Military Clinics.

INTRODUCTION: Despite a wide literature describing the impact of PTSD on military personnel, there is limited information concerning the results of PTSD treatment within military clinics mental health. Having such information is essential for making predictions about service members' chances of recovery, choosing best treatments, and for understanding if new interventions improve upon the standard of care. MATERIALS AND METHODS: We reviewed data from the Psychological Health Pathways (PHP) database. Psychological Health Pathways is a standardized battery of demographics and psychometric outcome measures, including measurement of PTSD symptom severity, that is collected in military mental health clinics. We examined changes in PTSD symptom severity scores over time and developed logistic regression models to predict who responded to treatment, showed clinical success, or improved to the point that they could likely stay in the military. RESULTS: After about 10 weeks in mental health clinics, severity scores for PTSD, sleep, depression, resilience, and disability all improved significantly. Of 681 patients tracked, 38% had clinically significant reductions on the PTSD Checklist (PCL) (i.e., "treatment response"), 28% no longer met criteria for PTSD on the PCL, and 23% did both (i.e., "clinical treatment success"). For the ultimate end point of "military treatment success," defined as meeting criteria for both clinical treatment success and reporting that their work-related disability was mild or better, 12.8% of patients succeeded. Depression scores were the most powerful predictor of treatment failure. CONCLUSIONS: Recovery from PTSD is possible during military service, but it is less likely in individuals with certain negative prognostic factors, most notably severe depression.

ORION: A novel solution for tracking service members exposed to trauma and providing targeted outreach.

In response to the USS Fitzgerald (FTZ) and USS John S. McCain (JSM) collisions in 2017, Navy Medicine developed the Organizational Incident Operational Nexus (ORION) to track Service members and conduct targeted outreach (Caring Contacts) to those at elevated risk for psychological injury after unit-level, non-combat trauma exposure. A 1-year pilot was conducted to test the feasibility of implementing ORION. During the pilot, crews from the FTZ and JSM received Caring Contacts twice, once in winter/spring of 2018 and once in the summer/fall of 2018. Caring Contacts included reaching out to Service members over email, checking in with Service members over the phone, and connecting them to mental health resources, if desired. Sixty-two percent of the crews of the FTZ and JSM completed Caring Contacts. The Caring Contacts were well received and one in five Service members requested assistance connecting to mental healthcare through ORION. Additionally, all paygrades from enlisted to officers and 66% of Service members who separated from Service requested assistance connecting to mental healthcare through ORION. Findings from the Caring Contacts also demonstrated that 50% of the crews needed mental health support after the collision, with 30% of Sailors reporting accessing care since the collision and an additional 20% requesting care during the Caring Contacts. Overall, results suggest Service members greatly benefited from ORION's proactive approach to confidential outreach. Navy Medicine is now working toward implementing ORION throughout the enterprise and collecting more data to refine the program. (PsycInfo Database Record (c) 2022 APA, all rights reserved).