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DOD Health Care: Mental Health and Traumatic Brain Injury Screening Efforts Implemented, but Consistent Pre-Deployment Medical Record Review Policies Needed

GAO-08-615 Published: May 30, 2008. Publicly Released: May 30, 2008.
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The John Warner National Defense Authorization Act for Fiscal Year 2007 included provisions regarding mental health concerns and traumatic brain injury (TBI). GAO addressed these issues as required by the Act. In this report GAO discusses (1) DOD efforts to implement pre-deployment mental health screening; (2) how post-deployment mental health referrals are tracked; and (3) screening requirements for mild TBI. GAO selected the Army, Marine Corps, and Army National Guard for the review. GAO reviewed documents and interviewed DOD officials and conducted site visits to three military installations where the pre-deployment health assessment was being conducted.


Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Defense In order to address the inconsistency in DOD's policies related to the review of medical record information and to assure that health care providers have reviewed the medical record when screening servicemembers prior to deployment, the Secretary of Defense should direct the Under Secretary of Defense for Personnel and Readiness to revise DOD's Instruction on Deployment Health to require a review of medical records as part of the pre-deployment health assessment.
Closed – Not Implemented
As of April 2012, DoD Instruction 6490.03 is currently under review. According to DoD, when revised in 2013 the Instruction will require a review of medical records as part of the pre-deployment health assessment. However, as this recommendation cannot be fully implemented until the DoD Instruction on Deployment Health is revised, this recommendation is determined to have not been implemented.

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Disease detection or diagnosisHealth care programsHealth care servicesMedical care evaluationMedical examinationsMedical recordsMental healthMental health care servicesMental illnessesMilitary forcesMilitary operationsMilitary personnelMilitary personnel recordsPolicy evaluationPost-traumatic stress disordersProgram evaluationRisk assessmentProgram implementationStandards (health care)