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    Subject Term: "Mental health care services"

    8 publications with a total of 34 open recommendations
    Director: Brenda S. Farrell
    Phone: (202) 512-3604

    6 open recommendations
    Recommendation: To help ensure that program staff are being used in an effective and efficient manner, and to facilitate the consideration and identification of total force solutions for staffing sexual assault prevention and response and Sexual Harassment/Assault Response and Prevention (SHARP) programs throughout the Department of the Army, the Secretary of Defense should direct the Secretary of the Army, in coordination with the Chiefs of the National Guard Bureau and the Army Reserve, to conduct an evaluation of staffing approaches used to administer the sexual assault prevention and response program, and consider opportunities to leverage resources across all Army components. This evaluation should include an assessment of the number and allocation of full-time and collateral-duty personnel, the fill rates for program positions, and the types of positions used.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To help ensure that Army National Guard and Army Reserve program staff have the necessary information to develop their budgets and to help ensure the efficient and effective use of program funds, the Secretary of Defense should direct the Secretary of the Army to direct the Army National Guard SHARP Program Office to communicate and disseminate its guidance on budget development and execution for the SHARP program to all full-time SHARP program personnel.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To help ensure that Army National Guard and Army Reserve program staff have the necessary information to develop their budgets and to help ensure the efficient and effective use of program funds, the Secretary of Defense should direct the Secretary of the Army to direct the Army Reserve SHARP Program Office to develop clear guidance on budget development and execution for the SHARP program and disseminate this guidance to its full-time SHARP program personnel.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To help ensure that Army National Guard and Army Reserve program staff have the necessary information to develop their budgets and to help ensure the efficient and effective use of program funds, the Secretary of Defense should direct the Secretary of the Army to direct the Director of the Army SHARP Program Office to expand the scope of the midyear review to include monitoring and providing oversight of SHARP program expenditures at the Army National Guard state and Army Reserve command level.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To help ensure that sexual assault crimes involving Army National Guard members are investigated in a timely manner, with a full investigation of the offense regardless of the reserve component or duty status of the victim, the Secretary of Defense should direct the Chief of the National Guard Bureau, in collaboration with the secretaries of the military departments as appropriate, to reassess the Office of Complex Administrative Investigation's (OCI) timeliness and resources to determine how to improve the timeliness of processing sexual assault investigations involving members of the Army National Guard, and identify the resources needed to improve the timeliness of these investigations.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: To help ensure that victims of sexual assault in the Army Reserve have timely access to medical and mental health-care services without having to pay for their care upfront, if they are eligible for care paid for or provided by DOD, the Secretary of Defense should direct the Secretary of the Army to direct the Chief of the Army Reserve to develop and implement an expedited line-of-duty determination process for Army Reserve sexual assault victims, along with a method for tracking the length of time to make the determinations. When developing this process, the Chief should ensure that it allows soldiers who wish to file a confidential or restricted report to go through the determination process without disclosing their circumstances to the chain of command.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Director: Brenda S. Farrell
    Phone: (202) 512-3604

    8 open recommendations
    Recommendation: The Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to incorporate medical screening questions specific to gambling disorder as part of a systematic screening process across DOD, such as DOD's annual Periodic Health Assessment, for behavioral and mental-health issues.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: The Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to update DOD Instruction 1010.04, Problematic Substance Use by DOD Personnel, to explicitly include gambling disorder as defined in the 2013 Diagnostic and Statistical Manual of Mental Disorders.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: The Secretary of Defense should direct the Secretary of the Army to update Army Regulation 600-85, The Army Substance Abuse Program, to explicitly include gambling disorder.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: The Secretary of Defense should direct the Secretary of the Navy to update Naval Operations Instruction 5350.4D, Navy Alcohol and Drug Abuse Prevention and Control, to explicitly include gambling disorder.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: The Secretary of Defense should direct the Secretary of the Air Force to update Air Force Instruction 44-121, Alcohol and Drug Abuse Prevention and Treatment (ADAPT) Program, to explicitly include gambling disorder.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: The Secretary of Defense should direct the Commandant of the Marine Corps to update Marine Corps Order 5300.17, Marine Corps Substance Abuse Program, to explicitly include gambling disorder.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: The Commandant of the Coast Guard should update Commandant Instruction M6000.1F, Coast Guard Medical Manual, to classify gambling disorder as an addiction and not as an impulse control issue.

    Agency: Department of Homeland Security: United States Coast Guard
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: The Commandant of the Coast Guard should update Commandant Instruction M1000.10, Coast Guard Drug and Alcohol Abuse Program, to explicitly include gambling disorder.

    Agency: Department of Homeland Security: United States Coast Guard
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Director: Kay E. Brown
    Phone: (202) 512-7215

    1 open recommendations
    Recommendation: To help states effectively address ongoing challenges related to ensuring the appropriate use of psychotropic medications for children in foster care, the Secretary of HHS should consider cost-effective ways to convene state child welfare, Medicaid, and other stakeholders to promote collaboration and information sharing within and across states on psychotropic medication oversight.

    Agency: Department of Health and Human Services
    Status: Open

    Comments: HHS agreed with this recommendation and provided examples of the virtual convening of contingency groups they employed to provide technical assistance and peer to peer networking in child welfare. The agency plans to offer additional technical assistance that is specifically related to the topic of mental health and psychotropic medication. GAO will consider closing the recommendation when the agency completes these efforts.
    Director: Randall B. Williamson
    Phone: (202) 512-7114

    1 open recommendations
    Recommendation: To enhance oversight of access to mental health care and help ensure that servicemembers have timely access to mental health care, the Secretary of Defense should direct the Assistant Secretary of Defense for Health Affairs to establish an access standard for mental health follow-up appointments and regularly monitor data on these appointments.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Director: Brenda S. Farrell
    Phone: (202) 512-3604

    7 open recommendations
    Recommendation: The Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to collect and monitor deployed civilians' perceptions related to mental health care.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: The Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to leverage recommendations made by the RAND Corporation in its 2014 report on mental health stigma in the military to update and clarify policies as needed to remove stigmatizing provisions, such as career restrictions that may be too limiting for individuals who have received mental health care.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: The Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to establish a clear, consistent definition of those barriers to care generally understood by DOD as "mental health care stigma," to include explanations of its causes or contributing risk factors and ways that stigma is apparent in behaviors and policies.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: The Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to establish goals for efforts to address barriers to care generally understood by DOD as "stigma reduction efforts," and performance measures that link to these goals.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: The Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to develop a method to collect and analyze information on barriers to seeking mental health care, including stigma, so that reliable data may be gathered and used to measure the effectiveness of stigma reduction efforts over time.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: The Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to designate an entity to coordinate efforts to reduce mental health care stigma, among other barriers to care.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Recommendation: The Secretary of Defense should direct the Under Secretary of Defense for Intelligence to reissue consolidated guidance, incorporating subsequent updates for the denial or suspension of access to classified information and for assignment to sensitive duties based solely on information about mental health care.

    Agency: Department of Defense
    Status: Open

    Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
    Director: Debra Draper
    Phone: (202) 512-7114

    1 open recommendations
    Recommendation: The Secretary of Defense should direct the Secretary of the Army to implement processes to review and monitor the Army military treatment facility prescribing practices for medications discouraged under the PTSD guideline and address identified deviations.

    Agency: Department of Defense
    Status: Open

    Comments: We requested an update on the status of this recommendation. As of June 21, 2016, we are waiting for a response from DOD.
    Director: Brenda S. Farrell
    Phone: (202) 512-3604

    6 open recommendations
    Recommendation: To improve DOD's ability to prevent sexual assaults of male servicemembers, to increase its responsiveness to male servicemembers who are sexually assaulted, and to help DOD's sexual assault prevention and response program realize the full benefit of the data it collects on sexual assault incidents, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness, in collaboration with the Secretaries of the military services, to develop a plan for data-driven decision making to prioritize program efforts.

    Agency: Department of Defense
    Status: Open

    Comments: DOD was contacted on July 26, 2016 for an update on efforts to address this recommendation and responded that they are working on the report required by the NDAA on male victims of sexual assault and they believe that the report will, at a minimum, take some steps to address this recommendation. DOD also noted that the report required by the NDAA is due in the first quarter of FY 17 and that they will provide us with a copy once it has been approved. We will provide updated information when we confirm any actions the agency has taken in response to this recommendation.
    Recommendation: To improve DOD's ability to prevent sexual assaults of male servicemembers, to increase its responsiveness to male servicemembers who are sexually assaulted, and to address challenges faced by male servicemembers as DOD continues to seek to transform its culture to address sexual assault, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness, in collaboration with the Secretaries of the military services, to develop clear goals with associated metrics to drive the changes needed to address sexual assaults of males and articulate these goals, for example in the department's next sexual assault prevention strategy.

    Agency: Department of Defense
    Status: Open

    Comments: DOD was contacted on July 26, 2016 for an update on efforts to address this recommendation and responded that they are working on the report required by the NDAA on male victims of sexual assault and they believe that the report will, at a minimum, take some steps to address this recommendation. DOD also noted that the report required by the NDAA is due in the first quarter of FY 17 and that they will provide us with a copy once it has been approved. We will provide updated information when we confirm any actions the agency has taken in response to this recommendation.
    Recommendation: To improve DOD's ability to prevent sexual assaults of male servicemembers, to increase its responsiveness to male servicemembers who are sexually assaulted, and to address challenges faced by male servicemembers as DOD continues to seek to transform its culture to address sexual assault, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness, in collaboration with the Secretaries of the military services, to include information about the sexual victimization of males in communications to servicemembers that are used to raise awareness of sexual assault and the department's efforts to prevent and respond to it.

    Agency: Department of Defense
    Status: Open

    Comments: DOD was contacted on July 26, 2016 for an update on efforts to address this recommendation and responded that they are working on the report required by the NDAA on male victims of sexual assault and they believe that the report will, at a minimum, take some steps to address this recommendation. DOD also noted that the report required by the NDAA is due in the first quarter of FY 17 and that they will provide us with a copy once it has been approved. We will provide updated information when we confirm any actions the agency has taken in response to this recommendation.
    Recommendation: To improve DOD's ability to prevent sexual assaults of male servicemembers, to increase its responsiveness to male servicemembers who are sexually assaulted, and to address challenges faced by male servicemembers as DOD continues to seek to transform its culture to address sexual assault, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness, in collaboration with the Secretaries of the military services, to revise sexual assault prevention and response training to more comprehensively and directly address the incidence of male servicemembers being sexually assaulted and how certain behavior and activities--like hazing--can constitute a sexual assault.

    Agency: Department of Defense
    Status: Open

    Comments: DOD was contacted on July 26, 2016 for an update on efforts to address this recommendation and responded that they are working on the report required by the NDAA on male victims of sexual assault and they believe that the report will, at a minimum, take some steps to address this recommendation. DOD also noted that the report required by the NDAA is due in the first quarter of FY 17 and that they will provide us with a copy once it has been approved. We will provide updated information when we confirm any actions the agency has taken in response to this recommendation.
    Recommendation: To improve DOD's ability to prevent sexual assaults of male servicemembers, to increase its responsiveness to male servicemembers who are sexually assaulted, and to help ensure that all of DOD's medical and mental health providers are generally aware of any gender-specific needs of sexual assault victims, and that victims are provided the care that most effectively meets those needs, the Assistant Secretary of Defense for Health Affairs should, in collaboration with the services' Surgeons General, systematically evaluate the extent to which differences exist in the medical and mental health-care needs of male and female sexual assault victims, and the care regimen, if any, that will best meet those needs.

    Agency: Department of Defense: Office of the Assistant Secretary of Defense (Health Affairs)
    Status: Open

    Comments: DOD was contacted on July 26, 2016 for an update on efforts to address this recommendation and responded that they are working on the report required by the NDAA on male victims of sexual assault and they believe that the report will, at a minimum, take some steps to address this recommendation. DOD also noted that the report required by the NDAA is due in the first quarter of FY 17 and that they will provide us with a copy once it has been approved. We will provide updated information when we confirm any actions the agency has taken in response to this recommendation.
    Recommendation: To improve DOD's ability to prevent sexual assaults of male servicemembers, to increase its responsiveness to male servicemembers who are sexually assaulted, and to help ensure that all of DOD's medical and mental health providers are generally aware of any gender-specific needs of sexual assault victims, and that victims are provided the care that most effectively meets those needs, the Assistant Secretary of Defense for Health Affairs should, in collaboration with the services' Surgeons General, develop and issue guidance for the department's medical and mental health providers--and other personnel, as appropriate--based on the results of this evaluation that delineates these gender-specific distinctions and the care regimen that is recommended to most effectively meet those needs.

    Agency: Department of Defense: Office of the Assistant Secretary of Defense (Health Affairs)
    Status: Open

    Comments: DOD was contacted on July 26, 2016 for an update on efforts to address this recommendation and responded that they are working on the report required by the NDAA on male victims of sexual assault and they believe that the report will, at a minimum, take some steps to address this recommendation. DOD also noted that the report required by the NDAA is due in the first quarter of FY 17 and that they will provide us with a copy once it has been approved. We will provide updated information when we confirm any actions the agency has taken in response to this recommendation.
    Director: Randall B. Williamson
    Phone: (202) 512-7114

    4 open recommendations
    Recommendation: To ensure DHA can accurately and consistently assess mental health provider staffing needs across each of the military services, the Secretary of Defense should direct the Secretaries of the Army, Air Force, and Navy to require the medical commands of each military service to include its estimated mental health provider staffing needs generated through PHRAMS in the requirements fields of DHA's quarterly mental health staffing reports.

    Agency: Department of Defense
    Status: Open

    Comments: As of July 2017, DOD officials have not implemented this recommendation. GAO considers it to be open. We will update the status of this recommendation when we receive additional information.
    Recommendation: The Secretary of Defense should direct the Assistant Secretary of Defense for Health Affairs to ensure DHA, through the PHRAMS contractor, continue to refine PHRAMS to incorporate the needs of the military services to reduce the need for additional service-specific methods of determining mental health provider staffing needs.

    Agency: Department of Defense
    Status: Open

    Comments: As of July 2017, DOD officials have not implemented this recommendation. GAO considers it to be open. We will update the status of this recommendation when we receive additional information.
    Recommendation: To ensure the Defense Health Agency (DHA) can accurately and consistently assess mental health provider staffing needs across each of the military services, the Secretary of Defense should direct the Secretaries of the Army, Air Force, and Navy to require the medical commands of each military service to report any additional service-specific methods they use to determine their final estimates of mental health provider staffing needs.

    Agency: Department of Defense
    Status: Open

    Comments: As of July 2017, DOD officials have not implemented this recommendation. GAO considers it to be open. We will update the status of this recommendation when we receive additional information.
    Recommendation: The Secretary of Defense should direct the Assistant Secretary of Defense for Health Affairs to require the National Capital Region Medical Directorate to include its estimated mental health provider staffing needs generated through PHRAMS in the requirements fields of DHA's quarterly mental health staffing reports.

    Agency: Department of Defense
    Status: Open

    Comments: As of July 2017, DOD officials have not implemented this recommendation. GAO considers it to be open. We will update the status of this recommendation when we receive additional information.