Cost Trade-Offs Between Accessing and Retaining Uniformed Mental Health Providers

The Military Health System does not have enough military mental health providers to meet demand among active-duty service members, despite efforts in the U.S. Department of Defense (DoD) to leverage special pays to recruit and retain staff. Maintaining adequate military mental health care services is important for maintaining the readiness of the overall force. To expand its mental health workforce and stabilize its care delivery system, DoD needs cost-effective options for increasing the force size of military mental health providers in both the short and long terms. In this study, the authors used the RAND Dynamic Retention Model to simulate how changing retention bonuses for uniformed mental health providers increased active component retention and per capita personnel cost. Using these results, the authors determined the most cost-effective way to increase the force size of the uniformed mental health provider workforce; specifically, accessing more providers or retaining more providers. The authors also compared military compensation for psychiatrists, clinical psychologists, social workers, and mental health nurse practitioners with expected civilian compensation for these types of providers. DoD leaders and personnel managers can use the key findings and recommendations offered to make informed choices among potential strategies for expanding its uniformed mental health workforce.