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Panel Recommends Improvements to Fight Against PTSD Among Troops and Veterans

A recent report published by the Institute of Medicine of the National Academies concludes that the Department of Defense’s efforts to combat post-traumatic stress disorder among veterans suffers from a lack of accountability, due to insufficient data.

PTSD is estimated to affect between 13 and 20 percent of the 900,000 servicemembers who have been deployed to Iraq, Afghanistan or both since 2001. (The report holds the number at 900,000, though the New York Times reports the number of troops who have been deployed to Iraq or Afghanistan at 2.6 million.) The report comes against a backdrop of a sharp rise in suicide rates among uniformed servicemembers, with suicide rates approaching one per day, according to the Associated Press. Higher PTSD rates are correlated with multiple deployments, length of deployments, and time spent “off the FOB.” The more time a servicemember spent “outside the wire,” the more likely they are to exhibit clinical symptoms of PTSD.

If estimates are correct, there could be nearly 200,000 War on Terror veterans struggling with PTSD as a result of their military experiences. The VA’s own figures show that in 2010, some 438,091 individuals were treated for PTSD. The study’s authors found that only a fraction of those identified as potentially needing services actually received professional care for their PTSD. The study’s authors also found that inadequate data collection was hampering the Department of Defense’s efforts to assess the value of different therapeutic approaches.

The panel found shortcomings in servicemembers’ and veterans’ access to needed services – particularly for Reservists and National Guardsmen and their families, and veterans in rural areas, far from VA centers and military installations.

The panel also found room for improvement in the following areas:

  • Access to early-intervention resources in combat zones. The study’s authors recognized the value of strong and caring leadership at the unit level while deployed, as well as servicemembers’ access to trained early intervention counseling resources.
  • Staffing. Despite the DoD and the Department of Veterans Affairs hiring thousands of mental health professionals nationwide, staffing levels are still below the estimated need, according to the report.
  • Crammed unit training and deployment schedules not allowing for time for therapy among active duty troops.
  • Methods and programs were not standardized across the country. 
  • Servicemembers were still concerned about stigma associated with seeking counseling for PTSD symptoms. (A 2007 survey found that 59 percent of soldiers and 49 percent of Marines believed their chain of command would treat them differently if they sought counseling for PTSD).*

“There is a tremendous amount of good-will effort in both departments to provide good treatment,” said committee chairman Dr. Sandro Galea to a New York Times reporter. “The challenge is that in the rush to deliver treatment, assessment and monitoring has not been implemented rigorously, and that is a missed opportunity.”

The panel also directed attention at a lack of empirical data to guide DoD and VA resourcing decisions. However, they also called for more emphasis on alternative therapeutic regimens, such as yoga, without referencing much in the way of empirical data about its effectiveness themselves.

In other recent news, another report by the Armed Forces Health Surveillance Center found that the rate of mental health disorders among active duty military has increased 65 percent since 2001, with nearly a million servicemembers diagnosed with a mental health disorder between 2011 and 2011. The increase was largely attributable to depressive and anxiety disorders and PTSD. Women were more prone to these diagnoses than men, according to the AFHSC. But that could be the result of selection bias: It is very possible that women are more likely to report suffering from these problems and seek help than men.

*Defense Health Board Task Force on Mental Health (June 2007). An Achievable Vision: Report of the Department of Defense Task Force on Mental Health.

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