Improving Access to Mental Health Services for Veterans, Service Members, and Military Families, 54783-54786 [2012-22062]

Agencies

• Executive Office of the President

[Federal Register Volume 77, Number 172 (Wednesday, September 5, 2012)]
[Presidential Documents]
[Pages 54783-54786]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-22062]




                        Presidential Documents 



Federal Register / Vol. 77 , No. 172 / Wednesday, September 5, 2012 / 
Presidential Documents

[[Page 54783]]


                Executive Order 13625 of August 31, 2012

                
Improving Access to Mental Health Services for 
                Veterans, Service Members, and Military Families

                By the authority vested in me as President by the 
                Constitution and the laws of the United States of 
                America, I hereby order as follows:

                Section 1. Policy. Since September 11, 2001, more than 
                two million service members have deployed to Iraq or 
                Afghanistan. Long deployments and intense combat 
                conditions require optimal support for the emotional 
                and mental health needs of our service members and 
                their families. The need for mental health services 
                will only increase in the coming years as the Nation 
                deals with the effects of more than a decade of 
                conflict. Reiterating and expanding upon the commitment 
                outlined in my Administration's 2011 report, entitled 
                ``Strengthening Our Military Families,'' we have an 
                obligation to evaluate our progress and continue to 
                build an integrated network of support capable of 
                providing effective mental health services for 
                veterans, service members, and their families. Our 
                public health approach must encompass the practices of 
                disease prevention and the promotion of good health for 
                all military populations throughout their lifespans, 
                both within the health care systems of the Departments 
                of Defense and Veterans Affairs and in local 
                communities. Our efforts also must focus on both 
                outreach to veterans and their families and the 
                provision of high quality mental health treatment to 
                those in need. Coordination between the Departments of 
                Veterans Affairs and Defense during service members' 
                transition to civilian life is essential to achieving 
                these goals.

                Ensuring that all veterans, service members (Active, 
                Guard, and Reserve alike), and their families receive 
                the support they deserve is a top priority for my 
                Administration. As part of our ongoing efforts to 
                improve all facets of military mental health, this 
                order directs the Secretaries of Defense, Health and 
                Human Services, Education, Veterans Affairs, and 
                Homeland Security to expand suicide prevention 
                strategies and take steps to meet the current and 
                future demand for mental health and substance abuse 
                treatment services for veterans, service members, and 
                their families.

                Sec. 2. Suicide Prevention. (a) By December 31, 2012, 
                the Department of Veterans Affairs, in continued 
                collaboration with the Department of Health and Human 
                Services, shall expand the capacity of the Veterans 
                Crisis Line by 50 percent to ensure that veterans have 
                timely access, including by telephone, text, or online 
                chat, to qualified, caring responders who can help 
                address immediate crises and direct veterans to 
                appropriate care. Further, the Department of Veterans 
                Affairs shall ensure that any veteran identifying him 
                or herself as being in crisis connects with a mental 
                health professional or trained mental health worker 
                within 24 hours. The Department of Veterans Affairs 
                also shall expand the number of mental health 
                professionals who are available to see veterans beyond 
                traditional business hours.

                    (b) The Departments of Veterans Affairs and Defense 
                shall jointly develop and implement a national suicide 
                prevention campaign focused on connecting veterans and 
                service members to mental health services. This 12-
                month campaign, which shall begin on September 1, 2012, 
                will focus on the positive benefits of seeking care and 
                encourage veterans and service members to proactively 
                reach out to support services.
                    (c) To provide the best mental health and substance 
                abuse prevention, education, and outreach support to 
                our military and their family members,

[[Page 54784]]

                the Department of Defense shall review all of its 
                existing mental health and substance abuse prevention, 
                education, and outreach programs across the military 
                services and the Defense Health Program to identify the 
                key program areas that produce the greatest impact on 
                quality and outcomes, and rank programs within each of 
                these program areas using metrics that assess their 
                effectiveness. By the end of Fiscal Year 2014, existing 
                program resources shall be realigned to ensure that 
                highly ranked programs are implemented across all of 
                the military services and less effective programs are 
                replaced.

                Sec. 3. Enhanced Partnerships Between the Department of 
                Veterans Affairs and Community Providers. (a) Within 
                180 days of the date of this order, in those service 
                areas where the Department of Veterans Affairs has 
                faced challenges in hiring and placing mental health 
                service providers and continues to have unfilled 
                vacancies or long wait times, the Departments of 
                Veterans Affairs and Health and Human Services shall 
                establish pilot projects whereby the Department of 
                Veterans Affairs contracts or develops formal 
                arrangements with community-based providers, such as 
                community mental health clinics, community health 
                centers, substance abuse treatment facilities, and 
                rural health clinics, to test the effectiveness of 
                community partnerships in helping to meet the mental 
                health needs of veterans in a timely way. Pilot sites 
                shall ensure that consumers of community-based services 
                continue to be integrated into the health care systems 
                of the Department of Veterans Affairs. No fewer than 15 
                pilot projects shall be established.

                    (b) The Department of Veterans Affairs shall 
                develop guidance for its medical centers and service 
                networks that supports the use of community mental 
                health services, including telehealth services and 
                substance abuse services, where appropriate, to meet 
                demand and facilitate access to care. This guidance 
                shall include recommendations that medical centers and 
                service networks use community-based providers to help 
                meet veterans' mental health needs where objective 
                criteria, which the Department of Veterans Affairs 
                shall define in the form of specific metrics, 
                demonstrate such needs. Such objective criteria should 
                include estimates of wait-times for needed care that 
                exceed established targets.
                    (c) The Departments of Health and Human Services 
                and Veterans Affairs shall develop a plan for a rural 
                mental health recruitment initiative to promote 
                opportunities for the Department of Veterans Affairs 
                and rural communities to share mental health providers 
                when demand is insufficient for either the Department 
                of Veterans Affairs or the communities to independently 
                support a full-time provider.

                Sec. 4. Expanded Department of Veterans Affairs Mental 
                Health Services Staffing. The Secretary of Veterans 
                Affairs shall, by December 31, 2013, hire and train 800 
                peer-to-peer counselors to empower veterans to support 
                other veterans and help meet mental health care needs. 
                In addition, the Secretary shall continue to use all 
                appropriate tools, including collaborative arrangements 
                with community-based providers, pay-setting 
                authorities, loan repayment and scholarships, and 
                partnerships with health care workforce training 
                programs to accomplish the Department of Veterans 
                Affairs' goal of recruiting, hiring, and placing 1,600 
                mental health professionals by June 30, 2013. The 
                Department of Veterans Affairs also shall evaluate the 
                reporting requirements associated with providing mental 
                health services and reduce paperwork requirements where 
                appropriate. In addition, the Department of Veterans 
                Affairs shall update its management performance 
                evaluation system to link performance to meeting mental 
                health service demand.

                Sec. 5. Improved Research and Development. (a) The lack 
                of full understanding of the underlying mechanisms of 
                Post-Traumatic Stress Disorder (PTSD), other mental 
                health conditions, and Traumatic Brain Injury (TBI) has 
                hampered progress in prevention, diagnosis, and 
                treatment. In order to improve the coordination of 
                agency research into these conditions and reduce the 
                number of affected men and women through better 
                prevention, diagnosis, and treatment, the Departments 
                of Defense, Veterans Affairs, Health and Human 
                Services, and Education, in coordination with the 
                Office of

[[Page 54785]]

                Science and Technology Policy, shall establish a 
                National Research Action Plan within 8 months of the 
                date of this order.

                    (b) The National Research Action Plan shall include 
                strategies to establish surrogate and clinically 
                actionable biomarkers for early diagnosis and treatment 
                effectiveness; develop improved diagnostic criteria for 
                TBI; enhance our understanding of the mechanisms 
                responsible for PTSD, related injuries, and 
                neurological disorders following TBI; foster 
                development of new treatments for these conditions 
                based on a better understanding of the underlying 
                mechanisms; improve data sharing between agencies and 
                academic and industry researchers to accelerate 
                progress and reduce redundant efforts without 
                compromising privacy; and make better use of electronic 
                health records to gain insight into the risk and 
                mitigation of PTSD, TBI, and related injuries. In 
                addition, the National Research Action Plan shall 
                include strategies to support collaborative research to 
                address suicide prevention.
                    (c) The Departments of Defense and Health and Human 
                Services shall engage in a comprehensive longitudinal 
                mental health study with an emphasis on PTSD, TBI, and 
                related injuries to develop better prevention, 
                diagnosis, and treatment options. Agencies shall 
                continue ongoing collaborative research efforts, with 
                an aim to enroll at least 100,000 service members by 
                December 31, 2012, and include a plan for long-term 
                follow-up with enrollees through a coordinated effort 
                with the Department of Veterans Affairs.

                Sec. 6. Military and Veterans Mental Health Interagency 
                Task Force. There is established an Interagency Task 
                Force on Military and Veterans Mental Health (Task 
                Force), to be co-chaired by the Secretaries of Defense, 
                Veterans Affairs, and Health and Human Services, or 
                their designated representatives.

                    (a) Membership. In addition to the Co-Chairs, the 
                Task Force shall consist of representatives from:

(i) the Department of Education;

(ii) the Office of Management and Budget;

(iii) the Domestic Policy Council;

(iv) the National Security Staff;

(v) the Office of Science and Technology Policy;

(vi) the Office of National Drug Control Policy; and

(vii) such other executive departments, agencies, or offices as the Co-
Chairs may designate.

                A member agency of the Task Force shall designate a 
                full-time officer or employee of the Federal Government 
                to perform the Task Force functions.

                    (b) Mission. Member agencies shall review relevant 
                statutes, policies, and agency training and guidance to 
                identify reforms and take actions that facilitate 
                implementation of the strategies outlined in this 
                order. Member agencies shall work collaboratively on 
                these strategies and also create an inventory of mental 
                health and substance abuse programs and activities to 
                inform this work.
                    (c)  Functions.

(i) Not later than 180 days after the date of this order, the Task Force 
shall submit recommendations to the President on strategies to improve 
mental health and substance abuse treatment services for veterans, service 
members, and their families. Every year thereafter, the Task Force shall 
provide to the President a review of agency actions to enhance mental 
health and substance abuse treatment services for veterans, service 
members, and their families consistent with this order, as well as provide 
additional recommendations for action as appropriate. The Task Force shall 
define specific goals and metrics that will aid in measuring progress in 
improving mental health strategies. The Task Force will include cost 
analysis in the development of all recommendations, and will ensure any new 
requirements are supported within existing resources.

[[Page 54786]]

(ii) In addition to coordinating and reviewing agency efforts to enhance 
veteran and military mental health services pursuant to this order, the 
Task Force shall evaluate:

(1) agency efforts to improve care quality and ensure that the Departments 
of Defense and Veterans Affairs and community-based mental health providers 
are trained in the most current evidence-based methodologies for treating 
PTSD, TBI, depression, related mental health conditions, and substance 
abuse;

(2) agency efforts to improve awareness and reduce stigma for those needing 
to seek care; and

(3) agency research efforts to improve the prevention, diagnosis, and 
treatment of TBI, PTSD, and related injuries, and explore the need for an 
external research portfolio review.

(iii) In performing its functions, the Task Force shall consult with 
relevant nongovernmental experts and organizations as necessary.

                Sec. 7. General Provisions. (a) This order shall be 
                implemented consistent with applicable law and subject 
                to the availability of appropriations.

                    (b) Nothing in this order shall be construed to 
                impair or otherwise affect:

(i) the authority granted by law to an executive department or agency, or 
the head thereof; or

(ii) the functions of the Director of the Office of Management and Budget 
relating to budgetary, administrative, or legislative proposals.

                    (c) This order is not intended to, and does not, 
                create any right or benefit, substantive or procedural, 
                enforceable at law or in equity by any party against 
                the United States, its departments, agencies, or 
                entities, its officers, employees, or agents, or any 
                other person.
                
                
                    (Presidential Sig.)

                THE WHITE HOUSE,

                    August 31, 2012.

[FR Doc. 2012-22062
Filed 9-4-12; 2:00 pm]
Billing code 3295-F2-P