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GAO: Pentagon’s mental health, TBI programs not tracked properly

KAISERSLAUTERN, Germany — Defense Department programs supporting psychological health and traumatic brain injury treatment and research are poorly coordinated, and the department has failed to provide reliable and comprehensive data on how more than $2.7 billion in funds for such programs have been used in recent years, according to a Government Accountability Office report.

The House Armed Services committee asked the GAO to determine how much funding had been used to support DOD psychological health and TBI activities in recent years and how those funds had been used.

From fiscal 2007 through fiscal 2010, Congress appropriated about $675 million, while more than $2 billion was drawn from Defense Health Program accounts for the treatment and research of TBI and psychological health, according to the report.

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Annual reports to Congress detailing these expenditures have been incomplete, the GAO report found. Data are unreliable and DOD does not clearly state what’s included in its figures, according to the report.

Also, there is no single entity coordinating DOD’s psychological health and TBI activities, the report said.

As a result, “DOD is hampered in its efforts to ensure that resources are used effectively to meet goals; and Congress and entities with oversight responsibility will be limited in their ability to obtain reliable information to guide their decisionmaking.”

The findings echo a recent RAND Corporation study that found no single source in DOD or any of the branches of service maintains a complete list of psychological health and TBI programs, tracks the development of new programs or has the resources to direct servicemembers and their families to which among the array of services that best meet their needs, the GAO notes.

DOD several years ago created an agency to serve as the department’s coordinating authority on psychological health and TBI matters. But GAO auditors found, as they had in previous studies, that the Defense Center of Excellence for psychological health and TBI lacked a clear mission.

GAO recommends that DOD revisit DCOE’s role and determine whether it or another organization should act as DOD’s coordinating authority for issues concerning psychological health and TBI.

Until a single organization is tasked with coordinating the department’s psychological health and TBI activities, “DOD’s ability to manage these activities will remain fragmented, and duplication of effort remains a possibility,” the GAO report states.

Other recommendations from the report: Include expenditure data in annual reports to Congress, as required; establish quality control mechanisms on psychological health and TBI data; and if patient care costs are provided in future annual reports, specify what they include. In written comments on a draft of this report, DOD concurred with all four recommendations, GAO auditors note.

GAO auditors conducted the latest study, released Wednesday, from June 2010 through this month. The report notes the growing public concern over post-traumatic stress disorder, which falls into the broader field of psychological health, and TBI, which are referred to as the “signature wounds” of the wars in Iraq and Afghanistan.

svanj@estripes.osd.mil

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