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NEW STUDY: 1 IN 5 RETURNING TROOPS SUFFER FROM PTSD
OR MAJOR DEPRESSION -- Yet, only slightly more
than half
seek treatment fearing it will harm their careers
And, study
says 19% of troops report possible traumatic
brain injury.
We have the latest study from the RAND
Corporation on the "Invisible Wounds of War."
And, it's not good news.
VA, DoD and the civilian mental health care
systems are not capable of handling the problems. There needs to be
a major push to expand all three systems to help our returning troops.
RAND study is here, and be sure to note the
companion study and other information...
http://www.rand.org/multi/military/veterans/
Video from ABC news about this report is here...
http://www.vawatchdog.org/08/nf08/nfAPR08/nf041808-10.htm
Video from CBS news about this report is here...
http://www.vawatchdog.org/08/nf08/nfAPR08/nf041808-11.htm
For more about PTSD, use the VA Watchdog search
engine...click here...
http://www.yourvabenefits.org/sessearch.php?q=ptsd&op=and
For more about traumatic brain injury, use the VA
Watchdog search engine...click here...
http://www.yourvabenefits.org/sessearch.php?q=traumatic+brain&op=ph
RAND press release on the study is here...
http://www.eurekalert.org/pub_releases/2008-04/rc-sfo041708.php
Press release below:
-------------------------
Contact: Warren Robak
robak@rand.org
310-451-6913
RAND Corporation
Study finds 1 in 5 Iraq and Afghanistan veterans
suffer from PTSD or major depression
Nearly 20 percent of military service members who have returned from Iraq
and Afghanistan -- 300,000 in all -- report symptoms of post traumatic
stress disorder or major depression, yet only slight more than half have
sought treatment, according to a new RAND Corporation study.
In addition, researchers found about 19 percent of returning service
members report that they experienced a possible traumatic brain injury
while deployed, with 7 percent reporting both a probable brain injury and
current PTSD or major depression.
Many service members said they do not seek treatment for psychological
illnesses because they fear it will harm their careers. But even among
those who do seek help for PTSD or major depression, only about half
receive treatment that researchers consider “minimally adequate” for their
illnesses.
In the first analysis of its kind, researchers estimate that PTSD and
depression among returning service members will cost the nation as much as
$6.2 billion in the two years following deployment -- an amount that
includes both direct medical care and costs for lost productivity and
suicide. Investing in more high-quality treatment could save close to $2
billion within two years by substantially reducing those indirect costs,
the 500-page study concludes.
“There is a major health crisis facing those men
and women who have served our nation in Iraq and Afghanistan,” said Terri
Tanielian, the project’s co-leader and a researcher at RAND, a nonprofit
research organization. “Unless they receive appropriate and effective care
for these mental health conditions, there will be long-term consequences
for them and for the nation. Unfortunately, we found there are many
barriers preventing them from getting the high-quality treatment they
need.”
The findings are from the first large-scale, nongovernmental assessment of
the psychological and cognitive needs of military service members who have
served in Iraq and Afghanistan over the past six years. The RAND study is
the first to comprehensively assess the current needs of returned service
members from all branches of the military.
Researchers concluded that a major national effort is needed to expand and
improve the capacity of the mental health system to provide effective care
to service members and veterans. The effort must include the military,
veteran and civilian health care systems, and should focus on training
more providers to use high-quality, evidence-based treatment methods and
encouraging service members and veterans to seek needed care.
Since October 2001, about 1.6 million U.S. troops have deployed to the
wars in Iraq and Afghanistan, with many exposed to prolonged periods of
combat-related stress or traumatic events. Early evidence suggests that
the psychological toll of the deployments may be disproportionately high
compared with physical injuries.
Tanielian and project co-leader Lisa Jaycox headed a group of 25 RAND
researchers who conducted a three-pronged assessment of the needs of
returning service members: a national survey of those who had served in
Iraq and Afghanistan to assess their psychological and cognitive injuries;
economic modeling to estimate the cost not only of providing needed
treatment, as well as the costs associated with lost productivity and
suicide; and an assessment of treatment services that are available to
service members, as well as barriers to treatment.
Researchers surveyed 1,965 service members from 24 communities across the
country to assess their exposure to traumatic events and possible brain
injury while deployed, evaluate current symptoms of psychological illness,
and gauge whether they have received care for combat-related problems.
Service members reported exposure to a wide range of traumatic events
while deployed, with half saying they had a friend who was seriously
wounded or killed, 45 percent reporting they saw dead or seriously injured
non-combatants, and over 10 percent saying they were injured themselves
and required hospitalization.
Rates of PTSD and major depression were highest among Army soldiers and
Marines, and among service members who were no longer on active duty
(people in the reserves and those who had been discharged or retired from
the military). Women, Hispanics and enlisted personnel all were more
likely to report symptoms of PTSD and major depressions, but the single
best predictor of PTSD and depression was exposure to combat trauma while
deployed.
Researchers found many treatment gaps exist for those with PTSD and
depression. Just 53 percent of service members with PTSD or depression
sought help from a provider over the past year, and of those who sought
care, roughly half got minimally adequate treatment.
“If PTSD and depression go untreated or are under treated, there is a
cascading set of consequences,” Jaycox said. “Drug use, suicide, marital
problems and unemployment are some of the consequences. There will be a
bigger societal impact if these service members go untreated. The
consequences are not good for the individuals or society in general.”
Service members report many reasons for not seeking treatment. Many are
worried about the side effects of medication or believe that family and
friends can provide more help than a mental health professional. Even more
reported that they worried seeking care might damage their career or cause
their peers to lose confidence in their abilities.
The RAND report recommends the military create a system that would allow
service members to receive mental health services confidentially in order
to ease concerns about negative career repercussions.
“We need to remove the institutional cultural barriers that discourage
soldiers from seeking care,” Tanielian said. “Just because someone is
getting mental health care does not mean that they are not able to do
their job. Seeking mental health treatment should be seen as a sign of
strength and interest in getting better, not a weakness. People need to
get help as early as possible, not only once their symptoms become severe
and disabling.”
Researchers also found an urgent need to train more mental health
providers throughout the U.S. health care system on delivering
evidence-based treatments to service members and veterans. While many
opportunities for treatment exist for active-duty personnel, there is no
system in place to monitor the quality of those services to ensure they
are getting the latest science-based forms of treatment.
The Department of Defense’s newly created Defense Center for Excellence
for Psychological Health and Traumatic Brain Injury may provide a historic
opportunity to change the culture of psychological health within the
military and to promote and monitor the use of high-quality care to
service members. The RAND report provides information that the center
could use to pursue these objectives through the use of innovative care
models and performance measurement techniques.
Researchers suggest special training programs are needed to instruct
mental health providers in the military, veterans and civilian health
systems about the type of evidence-based treatments needed by service
members. Only providers with such training should be eligible to treat
service members and payment programs should be retooled to reward
providers who use science-based treatments.
“It’s going to take system-level changes -- not a series of small
band-aids -- to improve treatments for these illnesses,” Tanielian said.
The RAND study estimates the societal costs of PTSD and major depression
for two years after deployment range from about $6,000 to more than
$25,000 per case. Depending whether the economic cost of suicide is
included, the RAND study estimates the total society costs of the
conditions for two years range from $4 billion to $6.2 billion.
The RAND study also estimates that about 320,000 service members may have
experienced a traumatic brain injury during deployment -- the term used to
describe a range of injuries from mild concussions to severe penetrating
head wounds. Just 43 percent reported ever being evaluated by a physician
for that injury.
While most civilian traumatic brain injuries are mild and do not lead to
long-term impairments, the extent of impairments that service members
experience and whether they require treatment is largely unknown,
researchers said. In the absence of a medical examination and prognosis,
however, service members may believe that their post-deployment
difficulties are due to head injuries even when they are not.
One-year estimates of the societal cost associated with treated cases of
mild traumatic brain injury range up to $32,000 per case, while estimates
for treated moderate to severe cases range from $268,000 to more than
$408,000. Estimates of the total one-year societal cost of the roughly
2,700 cases of traumatic brain injury identified to date range from $591
million to $910 million.
###
The report is titled “Invisible Wounds of War: Psychological and Cognitive
Injuries, Their Consequences, and Services to Assist Recovery.” The full
report and several summaries are available at
http://veterans.rand.org.
The project, jointly conducted by RAND Health and the RAND National
Security Research Division, was sponsored by a grant from the California
Community Foundation.
RAND Health, a division of the RAND Corporation, is the nation’s largest
independent health policy research program, with a broad research
portfolio that focuses on quality, costs and health services delivery,
among other topics.
The RAND National Security Research Division conducts research and
analysis for the Office of the Secretary of Defense, the Joint Staff, the
Unified Commands, the defense agencies, the Department of the Navy, the
U.S. intelligence community, allied foreign governments and foundations.
The RAND Corporation is a nonprofit research organization providing
objective analysis and effective solutions that address the challenges
facing the public and private sectors around the world. To sign up for
RAND e-mail alerts:
http://www.rand.org/publications/email.html
-------------------------
posted by Larry
Scott
Founder and Editor
VA Watchdog dot Org
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