Patrick H. DeLeon

A Health Policy Perspective

We appreciate the opportunity to comment on the review by Garland et al. (2013). Over the years, we have come to appreciate the significance of the Institute of Medicine (IOM) finding that: ‘‘The lag between the discovery of more efficacious forms of treatment and their incorporation into routine patient care is unnecessarily long, in the range of about 15–20 years. Even then, adherence of clinical practice to the evidence is highly uneven (IOM 2001, p. 155).’’ This delay in the translation of evidence to practice is unacceptable and must be addressed at both the policy and operational level. The Director of the National Institutes of Health (NIH) opined during his fiscal year 2013 Senate Appropriations Committee hearings that the newly established National Center for Advancing Translational Sciences (NCATS) would be a viable vehicle for beginning this process, especially in the area of drug development. Basic discovery and the development of therapies are interconnected and occur on a continuum. The translation of basic biological discoveries into clinical applications is a complex process. Despite huge investments in biomedical science and technology, current translational science in the public and private sectors has not been able to address the bottlenecks that lead to delays, long development times, high failure rates, and high costs. NCATS is dedicated to developing new methods for conducting translational science and bringing new medical products, particularly medications, to patients more efficiently. We would contend that NCATS and the establishment of a parallel entry (perhaps within the National Institute of Mental Health (NIMH)) for the translation of non-drug related therapies are critical for the mental health of children and adolescents. As the Director indicated, NIH possesses the expertise and enthusiasm to tackle this historical and most unfortunate implementation delay as a scientific problem. ‘‘By focusing on the development of innovative new methods for conducting translational science, as opposed to developing therapeutics themselves, NCATS can enable others to bring new medical products to patients in a highly efficient, costeffective manner (Collins 2012)’’. As noted by Garland et al. (2013), problems with access to mental health and developmental services are well documented in the pediatric realm. In addition, we appear to be taking steps backward in the provision of routine care services in the pediatric primary care community. Despite a 66 % increase in the coding of pediatric attention deficit/ hyperactivity disorder (ADHD), care for ADHD has shifted away from pediatricians who have traditionally provided this therapy to specialists (e.g., psychiatrists) (Garfield et al. 2012). The US Preventive Services Task Force (USPSTF) recommends that adolescents only be screened for major depression if systems are in place to ensure accurate diagnosis, psychotherapy and follow-up (AHRQ 2009). Given the frequency of pediatric and adolescent ADHD and major depression diagnoses and the paucity of pediatric mental health professionals of all disciplines, we P. H. DeLeon (&) American Psychological Association, Uniformed Services University of the Health Sciences, Bethesda, MD, USA e-mail: patdeleon@verizon.net

Identifying Policy Implications and Future Research Directions Regarding Military Community Support and Child Psychosocial Adjustment

INTRODUCTIONnAs former U.S. Army Surgeon General Horoho points out, a large fraction of what determines the health and readiness of our military families does not occur during appointments with professionals, but rather within the Lifespace-where health really happens.... Indeed, when children of military families experience psychosocial difficulties, such stress impacts the service members personal well-being and ability to focus at work, impairing their capacity to attend to the mission. As such, the Department of Defense (DoD) has instituted a family readiness system to bolster resiliency within military families, including children, e.g., by linking families with support networks. Bolstering military family resiliency, including the prevention of and effective intervention for child psychosocial problems, is an important issue at all levels of the DoD. Service members, leaders, and policy makers have a vested interest in promoting mission readiness and a healthy force. Research can play an important role in shaping decision-making by consolidating what is currently known and not known about a particular expertise area. To date, there has been no consolidation of research regarding outcomes associated with military community support and the programs that currently exist to bolster child and family resiliency. Given the importance of military families to mission readiness, a review of the relevant research is warranted.nnnMETHODSnThis commentary article reviews the literature on community support for military children, provides an overview of currently available resources, discusses concerns with the current provision of support services to military families, and offers recommendations for future research, policy, and implementation of military community support programs.nnnCONCLUSIONnAlthough there is a dearth of research on available support programs, there appears to be no lack of services available to military families. However, several steps could be taken to make these resources into a more supportive system. Family members must be able to identify what support services exist, distinguish which service is most suitable for their needs, and be able to readily access these services in a resource-conserving manner. Considerable overlap in support services seems to suggest limited coordination between organizations and service providers, particularly in regard to the government/civilian interface, which inherently lies outside of DoD control. This overlap suggests a redundancy, which may not be efficient economically or in regard to accessing support. There also may be some confusion over which support service is most suitable for the consumers need. Although some overlap is useful, such as the provision of different services to different populations (e.g., having separate programs for the Army, Navy, Air Force, and Marine subcultures), limited organization and parsimonious provision of services makes it particularly difficult for spouses and family members to navigate resources. Initial attempts are being made to organize and consolidate resources in both the government and civilian sectors. However, it is clear that these initiatives have not completely solved problems related to resource access, redundancy, and lack of research-supported efficacy.

Ronald E. Fox (1936–2018).

Presents an obituary of Ronald E. Fox (1936-2018). Fox was a visionary, trailblazer, and leader in the practice of psychology for over 50 years, renowned for his ability to bring psychologists together to meet societys most pressing needs. Fox envisioned a broad social role for professional psychology, moving beyond psychotherapy for people with psychological problems to encompass general health, prevention, and well-being. He also had a long history of involvement in the APA. He was always a step or two ahead of us-creating the Practice Directorate, supporting the APAs reorganization that created the directorate structure, urging all of us to contribute to political action. He was recognized for his contributions with many awards, including the Distinguished Career Contributions to Practice of Psychology Gold Medal Award from the American Psychological Foundation (1994) and the Raymond D. Fowler Award for Outstanding Contributions to APA (2009). (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Research Driven Policy: Is Financial Capacity Related to Dangerousness?

Current Veterans administration policy directly links a Veteran’s adjudged capacity to manage personal financial resources with their ability to purchase or possess a firearm, pursuant to the regulatory authority of the National Instant Criminal Background Check System (NICS). Preventing Veterans’ suicide is a highly laudable public health objective. Effectively utilizing scientific research to “inform” public policy is equally important. The authors should be congratulated for their efforts. However, it is important in utilizing large set population-based data, especially social science data, to evaluate policy alternatives that there be substantial face (i.e., clinical) validity. Correlation does not necessarily represent causation.