Military Psychological Health Enterprise: Post-Traumatic Stress Innovations (PTSI) Research Project

 

Transforming the Psychological Health System of Care in the US Military

MIT’s research project Military Psychological Health Enterprise: Post-Traumatic Stress Innovations (PTSI) began in February 2012 and ran through January 2016. The project origins can be traced back to 2007, when the Department of Defense (DoD) Task Force on Mental Health articulated a transformative vision for the Military Health System to create a culture of support for psychological health, provide a full continuum of care, and ensure sufficient and appropriate resources, championed by visible and empowered leaders. We worked with military leaders to: (1) assess the current ways behavioral health of active-duty service members is managed and help identify opportunities for improvement; (2) determine the levers for change; (3) create strategies and structures so the military can better meet the quadruple aims of service member readiness, better health, better care, and lower cost; and (4) prioritize and guide actions to achieve the desired future system. We focused on garrison-based care in the Army and Marine Corps, the two Services with the greatest need, and used simulation modeling to analyze the broader impact of post-traumatic stress disorder (PTSD) policies and changes on both active-duty military and veteran systems. The PTSI research team has produced six publication and twenty-five working papers, as well as eleven master’s theses and one doctoral dissertation, all of which are listed here.

For further information please contact Dr. Anne Quaadgras at aquaad@mit.edu

Overall Project Executive Summary

Published articles and book chapters:

  1. Ghaffarzadegan, N., and R.C. Larson. (2015). Posttraumatic Stress Disorder: Five Vicious Cycles that Inhibit Effective Treatment. U.S. Army Medical Department Journal, (4-15), 8–13.
  2. Ghaffarzadegan N, Ebrahimvandi A, Jalali MS (2016) A Dynamic Model of Post-Traumatic Stress Disorder for Military Personnel and Veterans. PLoS ONE 11(10): e0161405. doi:10.1371/journal.pone.0161405

  3. Glover, W. J., J. Plmanabhan, D. Rhodes, and D. Nightingale. (2015). Architecting the Future U.S. Military Psychological Health Enterprise via Policy and Procedure Analysis. Military Medicine, 180(8), 898–909
  4. Itzhaky, L., Y. Levin, H. Fingerhut, and Z. Solomon. (2014). Depression and PTSD Co-Morbidity: What are We Missing? Journal of Depression and Anxiety, 03(04), 1–6.
  5. Schultheis, E. and A. Glasmeier. (2015). Spatial Typologies of Care: Understanding the Implications of the Spatial Distribution of Off-Base Civilian Behavioral Health Providers Who Accept TRICARE Prime to Service Persons and Their Dependents. Military Medicine, 180(9), 979–985.
  6. Solomon, Z., H. Fingerhut, A. Snir, and M. Rosenbert. (2016). Long-term trajectories and recovery from PTSD. In E. J. Bromet (Ed.), Long-Term Outcomes in Psychopathology Research: Rethinking the Scientific Agenda (American Psychopathological Association). New York: Oxford University Press.
  7. Wang, J.Y.H., W.J. Glover, A.M. Rhodes, and D. Nightingale. (2013). A Conceptual Model of the Psychological Health System for U.S. Active Duty Service Members: An Approach to Inform Leadership and Policy Decision Making. Military Medicine, 178(6), 596–606.

Papers and book chapters under review:

  1. Ghaffarzadegan, N., A. Ebrahimvandi, and M.S. Jalali. (2015). A Simulation-Based Analysis of PTSD Prevalence among the US Military Personnel and Veterans in 2025. Submitted to Milbank Quarterly.
  2. Ghaffarzadegan, N., R.C. Larson, H. Fingerhut, M.S. Jalali, A. Ebrahimvandi, A. Quaadgras, and T. Kochan. (2016). Model-Based Policy Analysis to Mitigate Post-Traumatic Stress Disorder. Submitted for the book: J. R. Gil-Garcia, T. A. Pardo, & L. F. Luna-Reyes (Eds.), Policy Analytics, Modelling, and Informatics: Innovative Tools for Solving Complex Social Problems.

Working papers and reports submitted to DoD sponsors (MRMC, Army, USMC)

  1. DiBenigno, J. (2016). Command-Provider Relationships in Embedded Behavioral Health.
  2. Fingerhut, H. (2015). A Simulation Model to Predict Long-Term Posttraumatic Stress Disorder Prevalence Following Operation Iraqi Freedom and Operation Enduring Freedom: Executive Summary.
  3. Fradinho, J., A. Glasmeier, K. Kaplan, A. Quaadgras, S. Moga, C. Mealer, A. Bell, D. Livengood, and J. Fay (2015). The Marine Corps II MEF Psychological Health System: overview, findings and recommendations.
  4. Glasmeier, A., E. Schultheis, A. Sassi, C.L. Chuvala, A. Bell, and J. Fay (2016). The Emergent Psychological Health System at Marine Corps Base Camp Lejeune 2012-2015: Analysis and Recommendations.
  5. Kochan, T., J. Carroll, A. Glasmeier, R.C. Larson, A. Quaadgras and J. Srinivasan (2016). PTSI Final Report: Transforming the Psychological Health System of Care in the US Military.
    1. Srinivasan, J., J. Carroll, and J. DiBenigno (2016).Chapter 2: US Army: Transformation to a Behavioral Health System of Care. In Kochan et al (2016) PTSI Final Report: Transforming the Psychological Health System of Care in the US Military.
    2. Quaadgras, A., A. Glasmeier, and K. Kaplan (2016). Chapter 3: US Marine Corps: Building a comprehensive coordinated psychological health system. In Kochan et al (2016) PTSI Final Report: Transforming the Psychological Health System of Care in the US Military.
    3. Larson, R.C., N. Ghaffarzadegan, and H. Fingerhut. (2016) Chapter 4: Mathematical modeling. In Kochan et al (2016) PTSI Final Report: Transforming the Psychological Health System of Care in the US Military.
  6. Quaadgras, A., A. Glasmeier, and K. Kaplan (2016). Building a Better USMC Psychological Health System: Coordination Analysis and Design Recommendations.
  7. Srinivasan, J. (2016). A Service-Line Approach to Managing Integrated Mental Healthcare Services in the United States Army.
  8. Srinivasan, J. (2016). Building Research-Practice Partnerships to Enable Health Systems Transformation.
  9. Srinivasan, J. (2016). Lessons Learned from Implementing Embedded Behavioral Health at Four Army Installations.
  10. Srinivasan, J. (2016). Preliminary Evidence on the Effectiveness of Embedded Behavioral Health.
  11. Srinivasan, J. (2016). Transitional Care Needs of Army Beneficiaries using Mental Health Services.
  12. Srinivasan, J. (2016). Understanding Who, What and Where in Army Mental Health Services Delivery.
  13. Srinivasan, J. and M. Brown (2016). Developing an Episode of Care Construct for understanding mental health care quality.
  14. Srinivasan, J. and M. Brown (2016). Routine Measurement of Patient Reported Mental Health Outcomes in the United States Army.
  15. Srinivasan, J., J. Carroll, and J. DiBenigno (2016). A Three Lens Analysis on Army Transformation.
  16. Srinivasan, J. and J. DiBenigno (2014). The Emergent Psychological Health System at Marine Corps, Base Camp Lejeune 2012-2015: Analysis and Recommendations.
  17. Srinivasan, J. and J. DiBenigno (2014). Site Alpha Behavioral Health System of Care.
  18. Srinivasan, J. and J. DiBenigno (2014). Site Charlie Behavioral Health System of Care.
  19. Srinivasan, J. and J. DiBenigno (2015). Developing the Embedded Behavioral Health Checklists.
  20. Srinivasan, J. and J. DiBenigno (2015). Site Bravo Behavioral Health System of Care.
  21. Srinivasan, J. and C. Ivany (2016). From Organized Anarchy to a System of Mental Health Care in the United States Army.
  22. Srinivasan, J., C. Ivany, M. Dinneen, and J. Carroll (2016). A Trilateral Partnership to Enable Mental Health Systems Transformation in the United States Army.
  23. Srinivasan, J. and A. Mkrytchan (2016). Model-Based Exploration of Moving Behavioral Health Providers into Primary Care.

Theses and Dissertations

  1. Chafac, M. (2015). Data Analysis and Simulation Approach to Capacity Planning. MIT Engineering Systems Division. Massachusetts Institute of Technology.
  2. DiBenigno, J. (2016). Understanding Organizational Change in Response to Institutional Pressure: The Case of Army Mental Healthcare for Active-Duty Soldiers. MIT Sloan School of Management. Massachusetts Institute of Technology.
  3. Fingerhut, H. (2015). A Simulation Model to Predict Long-Term Posttraumatic Stress Disorder Prevalence Following Operation Iraqi Freedom and Operation Enduring Freedom. MIT Technology and Policy Program. Massachusetts Institute of Technology.
  4. Hess, J. T. (2012). Deployment related mental health care seeking behaviors in the U.S. military and the use of telehealth to mitigate their impacts on access to care. MIT Dept. of Aeronautics and Astronautics. MIT Engineering Systems Division.; MIT Technology and Policy Program. Massachusetts Institute of Technology.
  5. Ippolito, A. K. (2012). Architecting the future telebehavioral health system of care in the United States Army. MIT Engineering Systems Division. Massachusetts Institute of Technology.
  6. Kamin, C. M. (2012). Integration and the performance of large-scale health enterprises : field studies of psychological health delivery systems in the U.S. Military. MIT Engineering Systems Division. MIT Technology and Policy Program. Massachusetts Institute of Technology.
  7. Lyan, D. E. (2012). Performance Dynamics In Military Behavioral Health Clinics. MIT Engineering Systems Division. Massachusetts Institute of Technology.
  8. Meier, C. (2015). An Enterprise Architecting and Sustainability Pillars Investigation of a Cutting-Edge Health Care and Research Facility for Replication to Its Satellite Centers. MIT Engineering Systems Division. Massachusetts Institute of Technology.
  9. Plmanabhan, J. (2014). Mixed Methods approach towards analyzing the current state of a complex multi-level enterprise. MIT System Design and Management. Massachusetts Institute of Technology.
  10. Scott, S. P. (2012). Network governance for the provision of behavioral health services to the US Army. MIT Engineering Systems Division. Massachusetts Institute of Technology.
  11. Southerlan, E. C. (2013). Using enterprise architecting to investigate a complex, multilevel enterprise and create a framework for enterprise transformation. MIT Engineering Systems Division. Massachusetts Institute of Technology.
  12. Wang, J. Y. H. (2011). The impact of individual-, unit-, and enterprise-level factors on psychological health outcomes : a system dynamics study of the U.S. military. MIT Engineering Systems Division. MIT Technology and Policy Program. Massachusetts Institute of Technology.