november december 2020
RESTORING FACTS RRRREVIEW AND ANALYSIS to the public policy debate
CIVICS EDUCATION for the 21st century
HOW SCHOOL PRINCIPALS responded to COVID-19
WOUNDED WARRIORS
MENTAL HEALTH, SUBSTANCE USE, AND THE ROAD TO RECOVERY PAGE 10 R
Staffing Needs Planning as Introducing Continuity 1 in the U.S. 2 Freedom 3 the RAND Space 4 and Change in Secret Service The pandemic Enterprise China’s Foreign This user guide is has confined Initiative Policy part of a project designed Americans to their Watch this video to learn In September to help the U.S. Secret homes, kept them from more about the mission 2020, senior political Service determine offices and schools, and and goals of the Space scientist Andrew Scobell staffing needs in a separated them from Enterprise Initiative presented testimony subset of administrative, the people they love and and the importance of before the U.S.–China professional, and the activities they value. making space research Economic and Security technical work functions. If the U.S. had planned available to all. Review Commission. RAND researchers better, Americans might MORE AT MORE AT Five Picks from the Homeland be more free during the www.rand.org/v200904 www.rand.org/t/CTA774-1 Security Operational COVID-19 crisis. But Analysis Center there is a silver lining: analyzed organizational This experience could structures, workflows, provide lessons for how to and available data address other sweeping and compared these problems that require factors with possible planning, such as climate approaches to build tools change. for workforce planners MORE AT to use in making staffing www.rand.org/b200904plan determinations.
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Diversity in the 5 U.S. Air Force The Air Force experiences challenges in maintaining a demographically diverse civilian workforce. Researchers analyzed personnel data to better understand the challenges that civilian women, racial/ethnic minorities, and individuals with disabilities may face in advancing to higher pay grades as well as factors they consider when deciding whether to OFFICIAL1: DHS PHOTO BY BARRY BAHLER, BEARSKY23/ADOBE STOCK; 2: RYANJLANE/GETTY IMAGES; 3: ELEN11/GETTY IMAGES; 4: BEEBRIGHT/GETTY IMAGES; 5. U.S. AIR NATIONAL GUARD PHOTO BY MASTER SGT. MATT HECHT remain with the Air Force.
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The Civic Mind What students need to know about civic 14 responsibility
Závon Billups, shown here in a screen grab from a classroom video, teaches eighth- grade civics at a Boston charter school— not just how government works, but how to be active, engaged, and effective participants in it. He describes his students as “21st-century change agents.”
Think Help for Teaching Tanks in the Wounded and era of truth Warriors Learning decay Treating in the 8 10 mental health 18 age of and substance COVID-19 use disorders
Research Commentary At RANDom 2 Briefly Brain– 6 The decline 21 RAND rolls computer of American the dice interfaces and influence more
The Q&A Terri Giving 4 Tanielian, a voice 20 Making a for veterans lasting difference COVER DESIGN BY JESSICA ARANA/RAND CORPORATION; PHOTO COURTESY OF DAN SMEE
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C O R P O R A T I O N Research Briefly IMAGE CREDITS: GISELLEFLISSAK/GETTY CREDITS: IMAGE IMAGES
Investing in Disadvantaged Families For nearly 60 years, a learning center in Pasadena, Calif., has worked to uplift some of the most disadvantaged families in its community, parents and children alike. A recent RAND study adds to a growing body of evidence that programs like it can make a real and lasting difference. The Families Forward Learning Center provides free care and education to infants, toddlers, and preschoolers who are mostly living below the poverty line and learning English as a second language. It also provides parenting and English classes, among other supports, to their mothers. Most of the mothers interviewed by RAND researchers said their English had improved; so had their self-confidence and their ability to advocate for their children in school. Almost all said they were now more involved in their children’s educa- tion, helping them with homework and reading to them. The researchers also found that children who went through the program before kindergarten outperformed their peers on standardized tests in the third grade. The differences in their scores were “large and meaningful,” the researchers wrote— enough to make up some of the persistent school achievement gap between white and Latinx students. The study was small, and it’s possible that the parents who enrolled in the program would have been more engaged in their children’s education anyway. But the findings are in line with other studies that have shown promising results from such two-generation programs. Done well, parents and children both seem to benefit when learning becomes a family affair.
MORE AT www.rand.org/t/RRA358-1 2 RAND.ORG | NOVEMBER–DECEMBER 2020 IMAGE CREDITS: KRAS99/ADOBE STOCK; MATTHIEU/ADOBE STOCK; JACKIE NIAM/ADOBE STOCK; THINKNEO/GETTY IMAGES; ELENABSL/ADOBE STOCK selfie, which did a little better. alittle did which selfie, by quarantine in people monitor to Poland in used app an and criteria; none of the almost met which travel, regulate to Russia in used pass health adigital included Those cases. test as 20 countries from apps 40 rate The researchers used scorecard the to it. to access get can agencies enforcement law whether and anonymous, and it’s encrypted whether information, personal uses and collects app an how account into takes It phones. their off keep to which and trust, to apps which about decisions more-informed make users help can that scorecard asimple developed atRAND Researchers movements. and of auser’s locations surveillance government enable also might outbreak an map can that app An company. aprivate to information health sensitive feed also might afever flag can that app same The “download.” click they when up giving they’re what know to need at-home users But orders. stay- with compliance monitor even contacts, trace toms, symp check can that apps mobile with COVID-19 under of life realities new the to responded have Tech companies Surveillance Phone Mobile During Pandemics Brain–Computer Interfaces Brain–Computer information processing, improved physical performance, performance, physical improved processing, information computer-enhanced included lists wish technological Their ground. on the want would they capabilities human–computer what through think to asked ambush—and an surviving abuilding, clearing ascenario— given were players The wargame. atabletop play veterans—to combat and neuroscientists experts—including invited atRAND researchers like, look might that To what test aword. saying without members team their with municate com or to provide, senses five their than information more in take to them allow could implants Computer hands. their using without robots battlefield control or to drones, surveillance with directly communicate to soldiers enable could of technology kind that future, not-so-near the In minds. their with point amouse control to interfaces brain–computer used have quadriplegia with People flight. in for adrone commands into them translate and signals brain read can that electrodes developed already have Scientists happen. it making to obstacles biggest the not be might challenges cal technologi the found study RAND but arecent fiction, than science like less sound It may minds. their with machines engage to able be may fighters future that idea the into ing fund research put real to started has military U.S. The of Applications Military - - - - ers to pay a little more attention to protecting user data, data, user protecting to attention more alittle pay to ers develop for app need the underscores study The two. only met fully Israel from One criteria. scorecard 16 20 met of the fully for example, Australia, from app Acontact-tracing protections. privacy to it came when others outperformed far apps some category, that within even But close. too gets of COVID-19 case aconfirmed with someone when detect to aphone’s signal use They Bluetooth ers. trac contact were study the in apps common most The other way around. way other not the and technology, new for such demand the driving is need the sure make should funders other and military The attention. enough not received have they do—but could ahacker what imagine significant—just are risks The wrote. researchers the forward, going technologies computer of brain– development the guide should concerns Those first. world civilian the in adopted and tested, tried, been had technology the unless acomputer to brains their link to consent would ees enlist future that doubted they And considerations. ethical and moral outrun could speed atcomputer made sions deci that worried They of war. blur the in or intercepted jammed be could signals brain whether questioned Players asterisks. big some with came of those all But machines. other and of drones control mind direct and Center for Global Risk and Security Advisory Board. Advisory Security and Risk Global for Center RAND the of contributions generous the by part, in provided, also was project this for Support operations. from income and supporters RAND from gifts by provided was Funding security. global of future the shaping are that trends and technologies new about questions important big, tackles that initiative RAND 2040—a Security of is part research This www.rand.org/t/RR2996 AT MORE especially in the midst of a pandemic, the researchers researchers the of apandemic, midst the in especially
wrote. It also highlights an opportunity for the U.S. U.S. for the opportunity an highlights It also wrote. supporters and incomesupporters from operations. government to set some standards for data for data standards some set to government provided by gifts from RAND RAND from gifts by provided protection, to make sure short-term short-term sure make to protection, Funding for this research was was research this for Funding health concerns don’t long-term to lead concerns health privacy headaches. privacy www.rand.org/t/RRA365-1 AT MORE NOVEMBER–DECEMBER 202 RAND.ORG 3 0 |RAND.ORG - - - - The Q & A A Voice for Veterans on Capitol Hill
Terri Tanielian’s research has helped bring post-traumatic stress disorder and other “invisible wounds” of war out of the shadows. It has helped get military caregivers the support they so desperately need. And it has shown how the American health care system too often fails veterans, especially those in suicidal distress. Tanielian is a senior behavioral scientist at RAND, an internationally recognized expert on military and veteran health, and a frequent witness at congressional hearings. Earlier this year, she completed an assignment that allowed her to more directly inform good policy. She embedded full-time with the House I was really Committee on Veterans’ Affairs as a six-month fellow. She was there to provide nonpartisan support to the committee, to help it pursue policy ideas backed humbled by the by evidence. She worked with staff to help inform the committee’s agenda for the current congressional seriousness and session, including the chairman’s signature legislative proposal, the ACCESS Act. It would ensure all veterans get access to mental health care, regardless of their discharge status. the passion that RAND funded the fellowship as a pilot project, with the help of philanthropic support, and is considering the members of whether to expand the fellowship to more congressional committees, and more fields of research the committee and expertise, in the future. staff had for this topic, and their Q How did this fellowship What were you hoping to willingness to listen opportunity come about? accomplish? to what I could A I had testified in May 2019 about The original intent was to produce a report some of RAND’s research and analysis for the committee, with a framework and share about what on suicide prevention for veterans and some recommendations for how it could would work, what service members. I was in the audience for consider evidence-based policy solutions. the evidence says. another hearing on suicide prevention, and But the committee members and staff a member of the House Veterans’ Affairs wanted to move more quickly. So I became Committee approached me. She said, “I very much involved in crafting a strategy saw your testimony. Our chair has actually for the committee, producing real-time made suicide his No. 1 priority for this guidance and educating the members. session of Congress, and we’re thinking of bringing in a fellow. Would you be How did that impact the interested?” So we teamed up with RAND’s committee’s work? Congressional Relations team and RAND leadership to figure out how we could make I outlined what committee staff should something like this work. be doing to gather more information,
4 RAND.ORG | NOVEMBER–DECEMBER 2020 what policy solutions they should be pieces of legislation, all of them focused considering based on the evidence. When on suicide prevention and mental health. I drafted the framework, the staff said, “This is excellent. We need to brief the What are you working on now that chairman”—who quickly said, “We’re you’re back at RAND? going with it!” The committee sent out a We need to think about press release about how the committee’s I’m trying to get some more work off it through the lens of activities would be organized around the ground around helping military ending discrimination, this framework and its commitment to caregivers. I’ve also been looking at how push forward with comprehensive suicide we can deepen and expand our work on promoting economic prevention legislation. reducing veteran suicide risk. opportunities and access to health care, enacting Do any moments really stand out Has your fellowship experience smart gun policies. to you? inspired any of that work? All of those things are I helped name the Veterans’ Acute Crisis I’d say I’m emboldened by it, more essential components of Care for Emergent Suicide Symptoms—or greatly impassioned that we need to lean ACCESS—Act, one of the main pieces of further in if we’re going to make strides comprehensive suicide legislation the chairman introduced. I then in reducing the number of suicide deaths. prevention. So I want to went with staff to drop it in the “hopper” I’ve been doing mental health research make sure I’m focusing for new legislation in the U.S. Capitol. That for 25-plus years, but now I’m thinking was a memorable “pinch-me” moment. about how we could be working in more on research that’s really I also got to sit behind the members and interdisciplinary ways—not just through going to propel those write questions that hearing witnesses the lens of “get more people into mental policy solutions. would have to answer. I was really humbled health care.” We need to think about it by the seriousness and the passion that the through the lens of ending discrimination, members of the committee and staff had promoting economic opportunities and for this topic, and their willingness to listen access to health care, enacting smart gun to what I could share about what would policies. All of those things are essential work, what the evidence says. components of comprehensive suicide prevention. So I want to make sure I’m focusing on research that’s really going What happened with the legislation to propel those policy solutions. you worked on? COVID hit during my fellowship, and that really slowed things down. The intent had Terri Tanielian been to push forward quickly on these waits for a House bills on a bipartisan basis. But then work Committee on Veterans’ Affairs stopped for a couple of weeks, and when hearing to begin it resumed, the focus was really on the in the U.S. Capitol VA’s role in response to the pandemic. The Visitor Center. committee had a hearing in September 2020 to get formal feedback and discussion on the ACCESS Act, as well as 30 other GRACE EVANS/RAND CORPORATION GRACE
NOVEMBER–DECEMBER 2020 | RAND.ORG 5 Commentary The Lost Generation in American Foreign Policy By James Dobbins and Gabrielle Tarini
ver the past two balance seems the least likely. The decades, the United growth in the Soviet Union’s power States has experi- acted as a spur to American achieve- enced a dramatic ment, not an excuse for its absence. drop-off in interna- China has grown more powerful, but tional achievement. This has become this is more a problem for the future more pronounced under President rather than an explanation for the Trump, but the decline began during setbacks in American foreign policy the presidency of George W. Bush. over the past two decades. China was A recent RAND paper found that, not responsible for 9/11, the global throughout the 55 years following war on terror, the failure to stabilize World War II, successive U.S. admin- Afghanistan and Iraq, the Iranian and istrations racked up major foreign North Korean nuclear programs, the policy successes—American actions Great Recession, the rise of the Islamic that made enduring contributions to State, the Syrian and Libyan civil wars, peace and prosperity—at an average or Russian aggression in Ukraine. Nor rate of about once a year. Since 2001, was China even a serious impediment the pace of foreign policy achieve- to American efforts to address these ment has fallen to once every four challenges. years. The result has been a lost gen- The decline in American influence eration in American foreign policy. James Dobbins is a senior fellow and seems best explained by the classic distinguished chair in diplomacy and security and Among foreign affairs experts and cycle of hubris followed by nemesis. Gabrielle Tarini is a policy analyst at RAND. commentators, there is nearly uni- An American sense of omnipotence versal agreement on the decline, but was encouraged by victory in the a variety of explanations of the cause. Cold War and continued to mount Some attribute it to a series of bad throughout the following decade with policy choices, others to the partisan success in the first Gulf War, pacifica- deadlock and increasing insularity tion of the Balkans, and a generally of domestic politics, and still oth- buoyant economy. ers argue that America’s diminished Provoked by the attacks of 9/11 and influence simply reflects the shifting further encouraged by the rapid fall A version of this commentary appeared on The Hill balance of global power, notably the (thehill.com) in September 2020. Commentary gives of the Taliban, America’s leaders rise of China. RAND researchers a platform to convey insights announced a global war on terror, based on their professional expertise and often on There is something to all these expla- embraced a policy of military pre- their peer-reviewed research and analysis. nations, but a shift in the global power emption to deal with nuclear prolif-
6 RAND.ORG | NOVEMBER–DECEMBER 2020 erators, invaded Iraq, and declared President Jimmy Carter briefly flirted are not sharing in whatever progress their intention to turn that country with retrenchment, but, by the end is being registered nationally and into a democratic model for the rest of of his term, he had brokered a last- globally. And they have a valid point. the Middle East. ing peace between Israel and Egypt, Improvements in living standards for These multiple missions strained the committed the United States to the most Americans have slowed and for capacity of the United States. None defense of the Persian Gulf, begun some have ceased altogether, dashing was completed satisfactorily. Instead, covert support for the anti-Soviet the expectations of ever-expanding the United States found itself bogged insurgency in Afghanistan, secured prosperity set during the 30-year down in classic quagmires in Iraq European agreement to the deploy- boom that followed World War II. and Afghanistan and entangled in a ment of nuclear-armed intermediate- Over the past 40 years, the personal growing number of smaller conflicts range missiles, and reasserted the income of 90 percent of Americans throughout the Middle East and role of human rights in American has grown more slowly than that of North Africa. Then, in 2008, came the diplomacy. the country as a whole, the bottom Great Recession, which gave rise to a In 1980, Ronald Reagan was elected half are hardly growing at all, while populist reaction on both the right and president, and it was “morning in those in the top 1 percent have seen the left. The Tea Party and the Occupy America” again. Over the following their income grow several times Wall Street movements were eventu- decade, he and George H. W. Bush faster than the national rate. ally reabsorbed within the two major consolidated American leadership To sustain public support for con- parties, driving these still further of the free world; expanded democ- structive international engagement, apart. In 2016, a nontraditional candi- racy; deterred aggression; negotiated America’s leaders will have to do a date running on a populist, anti- nuclear-arms reductions; and helped better job ensuring that the resultant establishment, and anti-globalist plat- liberate Eastern Europe, reunify Ger- material benefits are distributed more form won the American presidency. many, and win the Cold War. While equitably. COVID-19—which has This sequence—success, overcon- the loss in Vietnam proved only a caused declines in employment and fidence, overstretch, failure, and economic activity on a scale compara- retreat—illustrates how domestic ble to the Great Depression and a loss politics, foreign policy, and external of American lives larger than any war events interacted to diminish Ameri- since 1945—offers a logical starting can influence. Yet these factors do not place for such a turnaround. account adequately for the depth and To regain the willing collaboration duration of the American decline. of international partners, U.S. lead- The Vietnam War cost more Ameri- ers will need to once again identify can lives than all of America’s 21st- American interests with those of the century conflicts combined. It ended rest of the world. They will need to with a humiliating loss and was practice competent statecraft, adopt brief drag on American global stand- prudent policies, and pursue realisti- accompanied by an economic shock ing, this century’s setbacks have led and oil embargo that slowed growth cally achievable objectives. They will many Americans to question the need to demonstrate continuity of worldwide. Yet American diplomacy most basic tenets of modern Ameri- quickly recovered its momentum in policy across successive administra- can foreign policy. In the decades tions because enduring achievements the wake of that lost war and the at- since, many Americans have come to tendant domestic turmoil. Elected in can rarely be consolidated within a feel that America’s global engagement single presidency. 1976, the year after the fall of Saigon, is not working for them, that they BACKGROUND PHOTO BY BLAKE BERGEN; REAGAN: AP PHOTO/U.S. WHITE HOUSE; CARTER: ASSOCIATED PRESS
NOVEMBER–DECEMBER 2020 | RAND.ORG 7 Think Tanks in the Era of Truth Decay
By Michael Rich, President and CEO, RAND Corporation
e are living toward the federal government, a any political party or demographic. through a majority of Americans say either It’s why nonpartisan think tanks like moment of crisis “frustrated” or “angry.” RAND are as important now as they that will define All of this points to a civic disease have ever been. who we are as that I’ve been calling “truth decay,” I’ve always said that RAND is an idea aW nation; yet we can’t even agree on and that has enfeebled our response as much as a research institute—a what’s real and what’s rumor. Our to everything from climate change belief that the best way to solve the political discourse too often amounts to domestic terrorism to a global most complex and difficult problems to opinions about opinions, shouted pandemic. It’s the diminishing role of is to begin with facts and objective
across a cable-television split screen. facts and analysis in American public analysis. In our early days, that meant PHOTOGRAPHY BALDWIN/RAND DIANE Asked to describe their feelings life, and it cuts much deeper than figuring out how to put a satellite into
8 RAND.ORG | NOVEMBER–DECEMBER 2020 orbit, or how to manage the threat of struggled to be heard. Some of global nuclear war. Today, it means those eras ended with new forms saving lives and livelihoods from of journalism, recommitted to COVID-19, building a more just and chasing down facts and holding equitable society, and responding Truth those in power to account. Others to the ever-changing threats of ended with government reforms an ever-accelerating world. Our decay aimed at earning back the trust of goal throughout has been to make the governed. None of them ended communities safer and more secure, without renewed faith in objective healthier and more prosperous. is the analysis to guide public policy. At RAND, we have never shied away As a research institute with two core from a problem because it is too existential values—quality and objectivity— difficult or too complex. We’ve made that’s our stock in trade. The countering truth decay one of our threat of problems we face, as a nation and a highest priorities because it is both, world, demand a workforce of people and because it threatens the very who can collect and analyze data, foundations of our democracy. our time. think through solutions, and provide In recent and soon-to-be-published has resulted in an echo chamber insights and recommendations studies, there’s a growing body of voices that agree with us—or a without spin or bias. The standards of evidence showing that people shouting gallery of those that don’t. we set at RAND—research that is don’t just lack trust in American The switch from one-hour network transparent and clear, based on the institutions like Congress or the news programs to 24-hour coverage best information, and temperate in media. They actively distrust them. did not come with a 24-fold increase tone—are meant to ensure that the They expect those institutions to in reported facts. We shouldn’t be bluest of blue-state Democrats and display some basic competence, to surprised when people use words like the reddest of red-state Republicans provide accurate information, to can trust our findings equally. perform their duties with integrity. “frustrated” or “angry” to describe And they just don’t see it. the national mood. When we launched a fundraising And so, often, they just walk away But here’s why I’m optimistic. campaign for the future of RAND from the public square. Last year, A few years ago, RAND endeavored earlier this year, we named it we asked hundreds of Americans to review all of the evidence for and “Tomorrow Demands Today.” That’s where they get their news. More than against some of the most common a different way of saying what French a quarter of them said they know ideas for reducing gun violence— writer Antoine de Saint-Exupéry where they could go for reliable tougher background checks, for once wrote, a line I’ve always thought facts and information—sources example, or weapon bans. We spoke directly to RAND: “Your job like newspapers or television news found that there was often a lack of is not to foresee the future, but to shows. They just don’t have the time reliable evidence either way. Federal enable it.” At this moment in history, or interest to bother. constraints on gun research had that means restoring facts and That kind of disengagement has created a factual vacuum around analysis to the core of American helped drive a wedge between what is one of our most vociferous debates. public policy. Everyone was just shouting into true and what we think is true. Crime The stakes could not be higher. the void. rates in American cities are far below As a longtime friend, a former the peaks we saw in the 1990s, but you That study, though, caught the chairman of the board at RAND, would hardly be alone if you thought attention of the Laura and John told me, RAND was established it has never been more dangerous to Arnold Foundation, now called more than 70 years ago to address walk down the street. The scientific Arnold Ventures. It brought together the existential threat of the time, evidence for childhood vaccines a research consortium to invest up to the Soviet Union and its nuclear has never been so strong, yet the $50 million in gun violence research. arsenal. Truth decay, he said, is the And Congress, which had resisted World Health Organization recently existential threat of our time. listed vaccine hesitancy as one of the funding research into gun violence for greatest threats to global health. 20 years, passed a bipartisan spending That, unfortunately, is the truth. bill to provide $25 million more. That’s what I mean when I talk about A version of this essay will appear in The Future of truth decay. The proliferation of cable We’ve seen periods before in Think Tanks and Policy Advice in the United States news shows and social media sites American history when the truth (James McGann, ed., Palgrave Macmillan, 2021).
NOVEMBER–DECEMBER 2020 | RAND.ORG 9 A FOCUS ON THE RESEARCH OF Eric R. Pedersen, Kathryn E. Bouskill, Stephanie Brooks Holliday, Jonathan Cantor, Sierra Smucker, Matthew L. Mizel, Lauren Skrabala, Aaron Kofner, and Terri Tanielian
Help for Wounded Warriors Delivering Effective Treatment Options for Veterans with Co-Occurring Disorders
By Doug Irving, Staff Writer
Dan Smee was walking on a dirt road near It was a trap. As a recent RAND study his home in California, a backpack slung showed, potentially tens of thousands of over his shoulders, when suddenly his eyes post-9/11 veterans like him have tried to were darting, his heart was pounding, and numb the symptoms of post-traumatic he was back in Iraq, back on patrol. stress disorder (PTSD) or depression with drugs or alcohol. That can keep them from He couldn’t sleep. He’d find himself in the seeking the long-term care they need, and smoking wreckage of an armored vehicle, becomes just one more barrier to climb groping around in the dark for his helmet, if they do. When Smee worked up the reaching to make sure his legs were still strength to ask for help, a social worker there. When the flashbacks got really told him to go get sober first. bad—when he felt himself falling back into a flooded Iraqi canal, the water closing “I was so out of my mind at that point that over his head—he chased them away with I didn’t even know which way to go,” he beer, whiskey, and sleeping pills. says now. “The more symptoms I had, the more I drank, the more I used Ambien. Everything kind of crashed in on me.” DESIGN: JESSICA ARANA/RAND CORPORATION; SOLDIER: COURTESY OF DAN SMEE; NUTOEIZUZA/GETTY IMAGES; TOMAZL/GETTY IMAGES; NATHANDERRICK/GETTY IMAGES
10 RAND.ORG | NOVEMBER–DECEMBER 2020 More than 10 percent of veterans who served in Iraq or Afghanistan developed PTSD from what they saw and experienced.
NOVEMBER–DECEMBER 2020 | RAND.ORG 11 The prevalence of mental health and substance use disorders NUTOEIZUZA/GETTY TOMAZL/GETTY IMAGES; IMAGES More than 10 percent of veterans who served in Iraq or Afghanistan developed PTSD from what they saw and experienced. Some estimates put the number closer to 30 percent. As many as 15 percent show signs of depression. And one large survey of injured veterans found that half of those who had PTSD or depression also screened positive for hazardous alcohol use or a substance use disorder. That survey was conducted by the Wounded Warrior Project, a nonprofit organization whose mission is to help veterans injured during the wars in Iraq and Afghanistan. In response to those findings, and to stories of people like Dan Smee struggling to get help, it asked RAND to investigate the state of care for veterans with co-occurring mental health and substance use disorders. The lead researcher on the project, Eric Pedersen, spent the early years of his career working with those very veterans in clinics run by the Department of Veterans Affairs. Some of his patients thought they needed alcohol or cannabis to sleep. Others couldn’t leave the house without calming their anxiety with illicit drugs. One large survey of injured veterans “Telling somebody to go get sober before you deal with their PTSD or depression, that’s just not going to work,” found that half of those who had said Pedersen, now a behavioral scientist at RAND. PTSD or depression also screened “They’re just never going to come back in for treatment. positive for hazardous alcohol use The drinking is the one coping strategy they have, and now you’re going to remove it before you treat their or a substance use disorder. underlying mental health disorder?” That reality is not always reflected in the treatment options available to veterans and others struggling with co- Instead, he soon found himself patrolling the dusty fields occurring disorders. Pedersen’s team reviewed thousands of eastern Iraq. He remembers the way the dirt fell like of in-patient treatment centers and out-patient clinics, and rain after the explosion that ripped a hole in the armored found that more than a quarter of them have no way to treat vehicle he was in, the moment of superhuman strength co-occurring mental health and substance use disorders that allowed him to escape that flooded canal in full at the same time. And even among those that did, the battle gear. researchers found no agreement on what good treatment looks like, no consistency—no standard plan of action to He was using Ambien to sleep by the time he came home. get someone like Dan Smee back on his feet. Within a few months, he had added six packs of beer and pints of Jack Daniels. He stayed inside his apartment, the lights turned low, unless he needed to venture out to re- Improving the delivery of supply. “The stuff that happened really started to wear on promising and effective me,” he says now. “The friends lost, the near misses, being blown up and shot at and all the crazy stuff that comes treatments with war. Things kind of unraveled for me.” Smee had served as a medic in the Army after high school, There are good, effective treatment protocols to help and reenlisted with the National Guard after 9/11. He people break that cycle of mental health and substance thought he would serve stateside, maybe guard an airport. use disorders, RAND’s study found. The VA, in particular,
12 RAND.ORG | NOVEMBER–DECEMBER 2020 has developed gold-standard treatments for veterans with They should make a point of screening every incoming co-occurring disorders, with the clinical evidence to prove patient for signs of such co-occurring disorders. And they they work. And yet, in interviews, the researchers found should provide more information about their approach to few providers who closely follow them. those disorders, what treatment protocols they follow, and Often, that was because of financial pressure. A treatment what veterans can expect when they get there. protocol might require 15 therapy sessions, for example; “We absolutely know that unhealthy substance use is a patient might only have the insurance to cover five. prevalent in our warrior population, and that it’s a signifi- Or a program designed for one-on-one sessions with a cant barrier to care,” said Michael Richardson, the vice psychiatrist might be repurposed for group therapy. Did president of independence services and mental health at those modified programs still help? Often, the treatment Wounded Warrior Project. He added, “The same treatments centers themselves couldn’t say for sure, because they don’t work for everyone, and integrated treatment ap- didn’t always follow up to make sure discharged patients proaches are one of the best ways we can address these hadn’t relapsed. challenges.” The researchers estimated that the average Wounded Dan Smee hit bottom in a police holding cell. He says he Warrior Project veteran lives within 15 minutes of a felt the presence of the devil there, and heard the voices of facility with some kind of program to treat co-occurring lost friends: “Hey, Smee, this ain’t you, man.” He describes disorders. But there was no way to tell what kind of care it as a moment of total clarity. it provides, what protocols it follows, or whether it could He went back to the VA, and this time got himself checked meet the specific needs of veterans. into a residential treatment facility for veterans with co- That could make a big difference. At one facility that did occurring disorders. He never looked back. Today, he’s a serve veterans, for example, staffers knew not to sched- social worker at the VA, a guide for other veterans work- ule appointments around rush hour. They understood ing through the same problems he did. “I struggled,” he that, for a veteran with PTSD, getting stuck in a traffic says. “If I can help another veteran not struggle like I did, jam could bring back memories of stopped convoys and then it’s all worthwhile. That’s my whole new mission and roadside bombs. purpose in life now.” “If you just want to go someplace, then sure, there’s some- He’s been sober for 14 years. place near you that says it can help with co-occurring disorders,” Pedersen said. “But in terms of quality? We’re not sure. We have these treatments that are out there, that we know work for veterans, but we need to do a better job to deliver them.” The VA and other treatment facilities should ensure they’re Improving Substance Use Care: Addressing Barriers to Expanding offering the full scope of evidence-based care that veter- Integrated Treatment Options for Post-9/11 Veterans is available for free download at www.rand.org/t/RR4354 ans with mental health and substance use disorders need.
There are good, effective treatment protocols to help people break the cycle of mental health and substance use disorders. COURTESY OF DAN SMEE
NOVEMBER–DECEMBER 2020 | RAND.ORG 13 A FOCUS ON THE RESEARCH OF Julia H. Kaufman, Laura S. Hamilton, Lynn Hu, David Grant, Claude Messan Setodji, and Matt Strawn
CivicThe Mind Teachers, Students, and the Importance of Civic Responsibility in Present-Day America
By Doug Irving, Staff Writer
Závon Billups teaches eighth-grade civics at Boston Collegiate Charter School in Dorchester, Mass.
14 RAND.ORG | NOVEMBER–DECEMBER 2020 ávon Billups spends his days fighting for truth, struggling against apathy, and doing his best to counter the snarling partisanship that has consumed American politics. He is, in other Zwords, a civics teacher. He describes his students as the change agents of the 21st century.
Civics was once the cornerstone of an guaranteed by the Bill of Rights. Yet they were American education. It’s not even a graduation at least somewhat confident that their students requirement in some places now—but that is would pick up those basics by the time they starting to change. A growing number of states graduate anyway. and school districts are re-recognizing “It’s so easy now to look things up on the —JULIA KAUFMAN a need for teachers like Billups to prepare their internet that teachers may think it’s less students for the sometimes-messy realities important to promote memorization,” study co- of democracy. author Laura Hamilton said. “Some educators Researchers at RAND have focused on civics argue that it’s more important to give students in recent years as a crucial front in the fight the tools they need to find that information and against “truth decay,” the diminishing role of apply it in the real world.” Civic Mind facts and analysis in American public life. In But the survey also showed that students often a recent survey, they asked hundreds of civics struggle to separate good information from and social studies teachers what they teach, bad. Almost all of the high school teachers, how they teach it, and what they think students and many of the grade-school teachers, said need to know to become those 21st-century students routinely make false claims in class change agents. based on unreliable media sources. Most of “It’s about being able to get out into the thick of the high school teachers said their students’ things and produce,” said Billups, who teaches inability to evaluate information they find eighth-grade civics at a Boston charter school. online is a moderate or major problem. “I’m getting a bit lofty here, but you need these Those findings echo concerns RAND specific skills to succeed in our current climate. researchers have raised as they work to better You need to see yourself as a stakeholder, as understand and counter truth decay. Two of someone who’s participating, not just someone the biggest trends they’ve identified, in fact, who learned about it from a book.” Civics today covers much more than just how a bill becomes a law, RAND’s survey found. Most of the high school teachers who responded said their students “absolutely” need to learn to be tolerant of different people and groups. They wanted their students to see themselves as global citizens, to develop good work habits, and to embrace the responsibilities of government by the people. They weren’t overly concerned that students memorize the 50 states, or learn about important periods in American history. Barely two-thirds thought it was “absolutely essential” that their students know the protections
NOVEMBER–DECEMBER 2020 | RAND.ORG 15 Comparison of Perceived Importance and Confidence Ratings for Public High School Social Studies Teachers in 2010 and 2019
Absolutely Essential Very/Somewhat Confident
2010 2019 2010 2019 To be tolerant of people and groups who are different from themselves 76% 80% 74% 92%*
To have good work habits such as being timely, persistent, and hardworking 80% 76% 50% 87%*
To embrace the responsibilities of citizenship such as voting and jury duty 78% 66%* 65% 82%*
To see themselves as global citizens living in an interconnected world 57% 66%* 52% 81%*
To identify the protections guaranteed by the Bill of Rights 83% 65%* 79% 91%*
To understand concepts such as federalism, separation of powers, and checks and balances 64% 53%* 69% 81%* To follow rules and be respectful of authority 60% 53% 61% 90%* To be knowledgeable about periods such as the American Founding, the Civil War, and the Cold War 63% 43%* 72% 88%*
To understand economic principles such as supply and demand and the role of market incentives 50% 43% 51% 75%*
To develop habits of community service such as volunteering and raising money for causes 43% 40% 57% 85%*
To be activists who challenge the status quo of our political system and seek to remedy injustice 37% 37% 37% 70%*
To know facts (e.g., the location of the fifty states) and dates (e.g., Pearl Harbor) 36% 32% 56% 83%*
NOTES: Findings from 2010 are from a report published by the American Enterprise Institute. Columns 1 and 2 are based on the following survey item: How important do you think it SHOULD be for your high school to teach students each of the following? Use a one to five scale where 1 is ‘not important at all’ and 5 is ‘absolutely essential.’ Columns 3 and 4 are based on the following survey item: How confident are you that by the time they graduate, most students from your high school have actually learned the following? (Response options: not at all confident, somewhat confident, very confident). * indicates that the difference between 2010 and 2019 results is statistically significantly different from zero (p < 0.05).
are a deepening sense of distrust among “A lot of us just skim through the news without Americans, and a growing disagreement over realizing how one verb, one adjective, can what is even true to begin with. Both flourish completely change the narrative,” Chang said. when that line between fact and opinion blurs. “At the end of the day, how a bill becomes law, “Teachers are clearly concerned that students I cover it, but most of us are pretty disconnected are not able to make sense of the media they’re from that process. If I can make my students using to obtain information,” Hamilton said. think about how they consume the news, In Jayson Chang’s classes at Santa Teresa how they approach and have conversations High School in San Jose, Calif., students start with other people, that is how we get learning to detect bias—including their own— an active citizenry, an empowered and from the ring of the first bell. He opened his informed citizenry.” civics course this fall with a pop quiz. He’d RAND’s survey found one other reason for call out a name or a phrase—“Donald Trump,” concern in America’s civics classrooms. “Black Lives Matter”—and his students would Teachers need more support, and better answer with whatever words came to mind. His materials, to really hold the line against truth point became clear pretty quickly. decay. Many reported spending four or more hours every week digging up news clips,
16 RAND.ORG | NOVEMBER–DECEMBER 2020 historical documents, or other materials to become 21st-century change agents. He spins use in class. A possible reason for that: a wheel to pick a topic, and then two students More than 10 percent thought the materials have to share their thoughts on it—not debate their district provides are factually inaccurate it, not try to win points, but educate each other or culturally inappropriate. about where they stand. “I’m not here to police That suggests there’s an opening for schools to what my students think, but to make sure they do more to help their students put some context have the tools to express it,” he said. to current events; understand how institutions On the other side of the country, the students work, and how they should work; and guard taking Chang’s pop quizzes are mostly high against the creeping spread of truth decay. school seniors who will graduate this spring. “This hopefully will push states, school So he uses a different measure of success. districts, and other advocates to think more “A lot of them,” he said, “are voters now.” about the need for better materials in civics and more training for teachers,” study Funding for this research was provided by gifts from RAND supporters and income from operations. coauthor and senior policy researcher Julia Kaufman said. “We’re entering this pivotal moment when heightened use of media is happening at the same time there’s growing The Civic Education in the Era of Truth Decay series is distrust of government and other institutions. available for free download So there’s a growing need for schools to at www.rand.org/civic-ed really focus on civic development.” In Boston, Závon Billups has a not-so-simple test to see whether his students are ready to
If I can make my students think about how they consume the news, how they approach and have conversations with other people, that is ‘‘ how we get an active citizenry, an empowered and informed citizenry.” —JAYSON CHANG DESIGN: PETE SORIANO/RAND CORPORATION; PHOTOS COURTESY OF ZÁVON BILLUPS AND JAYSON CHANG
NOVEMBER–DECEMBER 2020 | RAND.ORG 17 A FOCUS ON THE RESEARCH OF Melissa Diliberti, Heather L. Schwartz, Laura S. Hamilton, and Julia H. Kaufman Teaching and Learning in the Age of COVID-19 By Doug Irving, Staff Writer
s parents, teachers, and closure. When hurricanes swept through the students learned the hard way Houston area in 2017, for example, they tracked this year, not many schools had more than 1,000 schools that had to close for a plan in place to guide them ten or more days. Few offered any kind of dis- through an extended school tance learning. closure.A When COVID-19 emptied classrooms Then came the total school lockouts of COVID from coast to coast, it was—as one school spring. Within the span of a few weeks in official in Maine said—“literally like building March and April 2020, nearly every school in a new educational system overnight.” America had to DATA NOTE Insights from the American Educator Panels
MELISSA DILIBERTI, HEATHER L. SCHWARTZ, LAURA S. HAMILTON, JULIA H. KAUFMAN Prepared for a Pandemic? That’s the main story, but not the whole story, figure out how to How Schools’ Preparedness Related to Their Remote Instruction During COVID-19 from a RAND survey of school principals in the he emergence of coronavirus disease 2019 (COVID-19) in the United States in spring 2020 forced make distance nearly all U.S. schools to transition rapidly to remote learning. Unsurprisingly, schools were unequally prepared to meet this challenge. Findings from the RAND Corporation’s nationally rep- resentative surveys of K–12 grade public school teachers and principals, as well as information from school websites collected in spring 2020, highlight substantial disparities in schools’ curriculum Tcoverage, access to technology, and teacher training on remote learning topics (Center for Reinventing Public Education, 2020; Hamilton, Kaufman, and Diliberti, 2020; Harris et al., 2020). immediate aftermath of those COVID closures. A minority of U.S. public schools were prepared for a crisis on the level of COVID-19. During the learning work. 2017–2018 school year, only 46 percent of U.S. public schools had a written plan for dealing with a pandemic (Kemp, 2020). Public information was lacking as well; in 2016, only 38 states had a publicly available school health emergency plan (Uscher-Pines et al., 2018). In 2017, RAND researchers asked school and health officials how their schools could be prepared to continue teaching during prolonged building closures. Interviewees indicated that to provide quality instruction, they needed sufficient online infrastructure, including learning management systems (LMSs), home internet access for students, and teachers and families trained in using online instruction before the onset of a crisis. Interviewees also said that it would take substantial lead time Some districts, in fact, had thought through for schools to shift to online instruction for the first time (Schwartz et al., 2020). (Anecdotal evidence shows Some handed that schools that used online instruction before the COVID-19 pandemic were better positioned to switch to remote learning once on-the-ground instruction stopped [Eroh, 2020].) How did schools’ pre-pandemic preparation affect their transitions to remote learning? In this Data Note, we present descriptive evidence about how schools’ pre-pandemic planning translated into remote learning practices and principals’ confidence in student achievement during the COVID-19 pandemic. Our findings are based on a survey that we administered to a nationally representative sample of 957 public school princi- what an extended closure would look like, and pals via the RAND American Educator Panels (AEP). out thick packets In this survey, we asked principals about the infrastructure preparations that their schools had made before the COVID-19 pandemic (see Table 1). Specifically, we asked principals whether, before the pandemic started, their schools had undertaken the following five practices: 1. providing devices (e.g., laptops, tablets) to at least those students who need them 2. training teachers on delivering online instruction 3. using an LMS how they would keep students engaged and 4. providing fully online or blended learning courses 1 of homework for 5. establishing plans to deliver instruction during a prolonged school closure. learning at home. Principals in those districts C O R P O R A T I O N students to do were much more likely to say they expect no on their own. Others handed out laptops and Prepared for a drop-off in student performance. mobile hotspots. Pandemic? How Schools’ Preparedness “Schools need to get serious about getting these To better understand how schools were adjust- Related to Their plans and their technology infrastructure into ing to life under COVID, researchers turned to Remote Instruction During COVID-19 place,” said Heather Schwartz, a senior policy a unique panel of experts, the RAND American is available for free researcher at RAND who focuses on pre-K to 12 School Leader Panel. The panel provides a pool DRAZEN/GETTY IMAGES download at www. educational systems. “During a disruption, what rand.org/t/RRA168-3 of school principals who participate in periodic are you going to do? It could be a fire, it could be surveys on school issues; a separate but similar flooding, a hurricane, it could be influenza or panel covers teachers. Researchers were able Funding for this research some other type of pandemic. You can’t just go to ask nearly 1,000 principals about what they was provided by gifts buy 1,000 iPads and think you’re done.” were experiencing on the ground. from RAND supporters and income from She and other researchers at RAND had raised Nearly two-thirds of the principals said their operations. concerns in recent years about whether schools schools had provided laptops or other computer were prepared for the disruption of a long devices prior to COVID-19, at least to students
18 RAND.ORG | NOVEMBER–DECEMBER 2020 Nearly two-thirds of the principals said their schools had provided laptops or other computer devices prior to COVID-19, at least to students in need. Yet fewer than half said they had trained teachers to deliver online instruction or were offering fully online or blended courses.
Michelle Hansen, principal at Phoebe A. Hearst Elementary School, hands a laptop computer to the parent of a student that attends the school in Sacramento, Calif., Friday, April 10, 2020.
School Preparedness Levels Before the COVID-19 Pandemic INDICATORS OF PREPAREDNESS
64% 45% Provided devices, Used a learning 20% at least to students 47% management system Had plans for delivering in need Provided teacher 44% instruction during a training on delivering Offered fully online or prolonged school closure online instruction blended learning courses
Other important preparedness indicators—such as the percentage of students who have home internet access—exist in addition to the five preparedness indicators. In the survey, for example, only 55 percent of principals said that 90 percent or more of their students had access to the internet at home during the pandemic. Data on how many of these students had access to the internet at home before the pandemic began was not collected.
in need. Yet fewer than half said they had trained teachers to say they expected a lower level of student achievement to deliver online instruction or were offering fully online this fall than they saw last fall. or blended courses. Only one in five said they had made Large schools were more likely than small schools to have plans before the pandemic to deliver instruction during a taken some preparedness steps pre-pandemic, such as prolonged school closure. training teachers to deliver online instruction. Middle “That’s the number that I find most concerning,” said and high schools were better prepared than elementary Melissa Diliberti, an assistant policy researcher at RAND, schools. And schools with high numbers of students re- a Ph.D. student at the Pardee ceiving free or reduced-price lunch, a marker for poverty, RAND Graduate School, and were just as prepared, or unprepared, as schools with the lead author of the report. lower numbers. “It really shows that few The results point to a striking need for better planning at schools had this concept of a schools—and to the difference that could make in the lives prolonged closure in mind as of millions of students. something that could real- “COVID is going to leave a lasting impression on everyone istically happen. I hope that who’s alive right now,” Diliberti said. “We’re all going to TOP: AP PHOTO/RICH PEDRONCELLI; BOTTOM: DAMIRCUDIC/GETTY IMAGES number is going to be a lot higher now that schools have have a sense that this might not be the last time that some- had to live through this.” thing like this could happen. Schools and districts are The more prepared a school was, the researchers found, going to have to respond with plans to address long clo- the more likely it was to continue giving letter grades sures—not if but when they happen again in the future.” during the pandemic. The most prepared schools, in fact, Most principals in RAND’s survey didn’t seem to argue were 20 percentage points more likely than the least pre- with that. Fully 85 percent of them said one of their top pared schools to stick with letter grades. And principals in priorities when schools reopen will be planning for the schools that had a closure plan in place were less likely next big closure.
NOVEMBER–DECEMBER 2020 | RAND.ORG 19 Giving FRANK CLARK: Will it have an impact that outlasts me?
rank Clark doesn’t have important civic institutions in the He now serves as the chairman of the to look far to see where city: the Chicago Symphony, the RAND Social and Economic Policy RAND research can Adler Planetarium, the Museum of Advisory Board. The board provides make a difference. He’s Science and Industry, the Chicago strategic guidance and philanthropic a guiding force in the Community Trust. The son of a public support to research programs leadership circles of school teacher, married to a school covering everything from climate Chicago, a self-made psychologist, he served until recently change to economic disparities to man who’s built a second career out as the president of the Chicago Board criminal justice reform. Fof giving back. His commitment to of Education. He also chairs the National RAND—and especially to its work He jokes that people always assume Collaborative on Gun Violence on social and economic justice and he can’t say no. In reality, he said, Research, a philanthropic fund effective gun policy—grew from there. he asks himself one question established after RAND researchers “If you know Chicago, you know it’s before he commits to a cause or an highlighted a profound need for a wonderful city—beautiful, really— organization: Will it have an impact high-quality research on effective but there are aspects of it, parts of that outlasts me? gun policies. The fund, administered the city, that need help,” he said. “It’s by RAND, has awarded millions That’s what brought him to RAND. associated with poverty, with poor of dollars for scientific research He was at another board meeting education, with people who didn’t on gun policy. It is, Clark said, “an when a friend, tech titan Ellen get a fair shake in life. I got involved extraordinary effort to develop real, Hancock, told him about the research with RAND in the simple belief that impactful policy guidance.” she was seeing as a member of one of we will make a difference. It really RAND’s advisory boards. Intrigued, “These are issues that mean a lot to is as simple as that. This is a place he started digging into RAND’s work me, whether they’re environmental where you think that you’re getting on social and economic policy. In issues, social and economic issues, or something done.” its research on the criminal justice looking for ways to respect people’s Clark got his start in the mailroom system, in particular, he found rights but also quell some of the of the local electric company, objective, fact-based ideas to address gun violence that takes place in this Commonwealth Edison, in 1966. Over the unequal treatment he saw all country,” he said. the next 40 years, he worked his way too often in Chicago and across the “It boils down to trying to make a up the ranks while also attending country. difference in life and leaving this night school to earn his college and He was sold. “It was this idea of being world a better place than you found law degrees. By the time he became a part of something that will make when you entered it,” he added. “The the company’s first Black president in a real change in the lives of people, research I see at RAND will not just 2001, ComEd was one of the largest that will affect our policy, that will benefit Chicago, or Illinois, but people utilities in the country. He retired in hopefully make the lives of people throughout the United States and, I 2012 as the chairman and CEO.
better and more affordable,” he said. think, throughout the world.” PHOTOGRAPHY BALDWIN/RAND DIANE He has devoted his time and energy since then to some of the most For more information about giving, visit campaign.rand.org.
20 RAND.ORG | NOVEMBER–DECEMBER 2020 at RANDom Take Me out to the Wargame By Melissa Bauman
AND is famous “a dangerous precedent” for its Pentagon or “everyone’s favorite wargames. Now scapegoat.” Players flip over the public can a value card from a stack, play defense each person plays one of analyst, too, if the concept cards they were Rthey have $250 to spare. dealt, and a (hopefully) RAND’s latest game is friendly debate begins as Hedgemony. Unlike Risk, players defend their cards. which pits one army against The goal is to talk politics another, Hedgemony with less heat—and without players create a defense having to reveal your actual strategy to allocate troops views to cranky Uncle Hank. and resources and “hedge” Still, RAND is no Hasbro, against the unknown. In and most of its games aren’t other words, Hedgemony for public consumption. The players make the defense 1954 game MonopoLOGs is policies that Risk’s troops about military procurement, would carry out. The game’s but most people aren’t in creators say it’s aimed at the market for an aircraft policymakers, war colleges, carrier. RAND’s Game of and researchers—but they Science was created in 1965, didn’t rule out family game but good luck deciphering night. “It depends on the the rules. There’s also the family!” said Michael Linick, 1957 game of SWAP— a RAND researcher involved Strategic War in the creation of the game. Planning—that A more layperson-friendly takes about 10 RAND-related game is days to finish. ControVersus, created in And those are 2019. It has sets of “concept” just a few of the cards with topics like “anti- games people vaxxers” or “the 24-hour play—at least news cycle,” and “value” at RAND.
DIE: TRANS/ADOBE STOCK; BACKGROUND: DORI WALKER/RAND PHOTOGRAPHY; HEDGEMONY BOX DESIGN: RICK PENN-KRAUS/RAND CORPORATION cards with phrases like
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