SEC. 2. ESTABLISHMENT BY DEPARTMENT OF VETERANS 
AFFAIRS AND DEPARTMENT OF DEFENSE OF 
CLINICAL PRACTICE GUIDELINES FOR CO-
MORBID MENTAL HEALTH CONDITIONS SUCH 
AS PTSD, MST, AND/OR TBI. 
(a) IN GENERAL.—Not later than two years after the 
date of the enactment of this Act, the Secretary of Vet-
erans Affairs, in consultation with the Secretary of De-
fense and the Secretary of Health and Human Services, 
shall complete the development of clinical practice guide-
lines for the treatment of post-traumatic stress disorder, 
military sexual trauma, and traumatic brain injury that 
is comorbid with substance use disorder or chronic pain. 
(b) WORK GROUP.— 
(1) ESTABLISHMENT.—In carrying out sub-
section (a), the Secretary of Veterans Affairs, the 
Secretary of Defense, and the Secretary of Health 
and Human Services shall create a Trauma and Co-
morbid Substance Use Disorder or Chronic Pain 
Work Group (in this section referred to as the 
‘‘Work Group’’). 
(2) MEMBERSHIP.—The work group created 
under paragraph (1) shall be comprised of individ-
uals that represent Federal Government entities and 
non-Federal Government entities with expertise in 
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the areas covered by the work group, including the 
following: 
(A) Academic institutions that specialize in 
research for the treatment of conditions de-
scribed in subsection (a). 
(B) The National Center for Posttraumatic 
Stress Disorder of the Department of Veterans 
Affairs. 
(C) The Office of the Assistant Secretary 
for Mental Health and Substance Use of the 
Department of Health and Human Services. 
(3) RELATION TO OTHER WORK GROUPS.—The 
Work Group shall be created and conducted in the 
same manner as other work groups for the develop-
ment of clinical practice guidelines for the Depart-
ment of Veterans Affairs and the Department of De-
fense. 
(c) MATTERS INCLUDED.—In developing the clinical 
practice guidelines under subsection (a), the Work Group, 
in consultation with the Post Traumatic Stress Disorder 
Work Group, Concussion-mTBI Work Group, Opioid 
Therapy for Chronic Pain Work Group, and Substance 
Use Work Group, shall ensure that the clinical practice 
guidelines include the following: 
(1) Guidance with respect to the following: 
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(A) The treatment of patients with post- 
traumatic stress disorder who are also experi-
encing a substance use disorder or chronic pain. 
(B) The treatment of patients experiencing 
a mental health condition, including anxiety, de-
pression, or post-traumatic stress disorder as a 
result of military sexual trauma who are also 
experiencing a substance use disorder or chron-
ic pain. 
(C) The treatment of patients with trau-
matic brain injury who are also experiencing a 
substance use disorder or chronic pain. 
(2) Guidance with respect to the following: 
(A) Appropriate case management for pa-
tients experiencing post-traumatic stress dis-
order that is comorbid with substance use dis-
order or chronic pain who transition from re-
ceiving care while on active duty in the Armed 
Forces to care from health care networks out-
side of the Department of Defense. 
(B) Appropriate case management for pa-
tients experiencing a mental health condition, 
including anxiety, depression, or post-traumatic 
stress disorder as a result of military sexual 
trauma that is comorbid with substance use dis-
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order or chronic pain who transition from re-
ceiving care while on active duty in the Armed 
Forces to care from health care networks out-
side of the Department of Defense. 
(C) Appropriate case management for pa-
tients experiencing traumatic brain injury that 
is comorbid with substance use disorder or 
chronic pain who transition from receiving care 
while on active duty in the Armed Forces to 
care from health care networks outside of the 
Department of Defense. 
(3) Guidance with respect to the treatment of 
patients who are still members of the Armed Forces 
and are experiencing a mental health condition, in-
cluding anxiety, depression, or post-traumatic stress 
disorder as a result of military sexual trauma that 
is comorbid with substance use disorder or chronic 
pain. 
(4) Guidance with respect to the assessment by 
the National Academies of Sciences, Engineering, 
and Medicine of the potential overmedication of vet-
erans, as required pursuant to the Senate report ac-
companying S. 1557, 115th Congress (Senate Re-
port 115–130), under the heading ‘‘Overprescription 
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Prevention Report’’ under the heading ‘‘COMMITTEE 
RECOMMENDATION’’. 
(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to prevent the Secretary of Vet-
erans Affairs and the Secretary of Defense from consid-
ering all relevant evidence, as appropriate, in creating the 
clinical practice guidelines required under subsection (a) 
or from ensuring that the final clinical practice guidelines 
developed under such subsection and subsequently up-
dated, as appropriate, remain applicable to the patient 
populations of the Department of Veterans Affairs and the 
Department of Defense. 
SEC. 3. UPDATE OF CLINICAL PRACTICE GUIDELINES FOR 
ASSESSMENT 
AND 
MANAGEMENT 
OF 
PA-
TIENTS AT RISK FOR SUICIDE BY TAKING 
INTO CONSIDERATION GENDER- AND AGE- 
SPECIFIC RISK FACTORS AND GENDER- AND 
AGE-SPECIFIC 
TREATMENT 
EFFICACY 
OF 
PHARMACOTHERAPY AND PSYCHOTHERAPY. 
(a) IN GENERAL.—Not later than two years after the 
date of the enactment of this Act, the Secretary of Vet-
erans Affairs and the Secretary of Defense, through the 
Assessment and Management of Patients at Risk for Sui-
cide Work Group (in this section referred to as the ‘‘Work 
Group’’), shall issue an update to the VA/DOD Clinical 
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Practice Guideline for Assessment and Management of 
Patients at Risk for Suicide. 
(b) MATTERS INCLUDED.—In carrying out the up-
date under subsection (a), the Work Group shall ensure 
that the clinical practice guidelines updated under such 
subsection includes the following: 
(1) Enhanced guidance with respect to the fol-
lowing: 
(A) Gender- and age-specific risk factors 
for suicide and suicidal ideation. 
(B) Gender- and age-specific treatment ef-
ficacy for depression and suicide prevention. 
(C) Gender- and age-specific pharmaco-
therapy efficacy. 
(D) Gender- and age-specific psychothera-
py efficacy. 
(2) Guidance with respect to the efficacy of al-
ternative therapies, other than psychotherapy and 
pharmacotherapy, including the following: 
(A) Yoga therapy. 
(B) Meditation therapy. 
(C) Equine therapy. 
(D) Other animal therapy. 
(E) Training and caring for service dogs. 
(F) Agri-therapy. 
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