title: Implementation and dissemination of military informed and evidence-based interventions for community dwelling military families.
abstract: Community dwelling military families from the National Guard and Reserve contend with deployment-related stressors in relative isolation, living in communities where mental health providers may have little knowledge of military culture. When they are community residents, active duty service members and families tend to live in close proximity to their military installations. This article will focus primarily on the challenges to quality mental health care for reserve component (RC) families. Where studies of RC families are absent, those of active component (AC) families will be highlighted as relevant. Upon completion of a deployment, reintegration for RC families is complicated by high rates of symptomatology, low service utilization, and greater barriers to care relative to AC families. A paucity of providers skilled in evidence-based treatments (EBTs) limits community mental health capacity to serve RC military families. Several emergent programs illustrate the potential for better serving community dwelling military families. Approaches include behavioral health homes, EBTs and treatment components, structured resiliency and parent training, military informed schools, outreach methods, and technology-based coping, and psychoeducation. Methods from implementation science to improve clinical skill acquisition and spread and sustainability of EBTs may advance access to and quality of mental health treatment and are reviewed herein. Recommendations related to research methods, military knowledge and treatment competencies, and transition to a public health model of service delivery are discussed.
authors.affiliation: Duke University School of Medicine, Durham, NC, USA, robert.murphy@duke.edu.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Murphy
authors.forename: John A
authors.initials: JA
authors.lastname: Fairbank
mesh_terms: D055317:Evidence-Based Practice / Q000592:standards*; D005192:Family Health; D006801:Humans; D008605:Mental Health Services / Q000592:standards* / Q000706:statistics & numerical data; D008889:Military Personnel / Q000523:psychology*; D014481:United States