Study Estimates Huge Need for US Military Mental Health Care

Voice of America News, PENTAGON: A prominent research organization estimated Thursday that 300,000 of the 1.5 million U.S. troops who have served in Iraq or Afghanistan have symptoms of post traumatic stress disorder or major depression, and a similar number may have suffered traumatic brain injuries, mainly from explosions. The Pentagon welcomed the study, and says it is working on the issues. 
 
The co-leader of the study by the Rand Corporation, Terri Tanielian, calls the situation “a major health crisis” that could have “long-term consequences” if it is not addressed. Among her findings are that only about half of the Iraq and Afghanistan war veterans who have symptoms of post traumatic stress disorder, depression and traumatic brain injury have sought treatment, and only half of those received adequate treatment. 
 
“We were able to assess when those folks did get care, what type of care they got and whether it met criteria for what we would define as an adequate dose of treatment,” said Terri Tanielian. “And too few were getting what we would define as a minimally adequate set of services.” 
 
Tanielian's 500-page study – based on interviews with 1,900 service members – says mental health problems are particularly prominent among combat veterans who are women or members of the reserves. It also estimates that the mental and brain disorders from the wars could cost the U.S. economy more than $6 billion over the next two years. But it says $2 billion of that could be saved if treatment is improved. 
 
Colonel Loree Sutton of the Pentagon's Center for Excellence on post traumatic stress disorder and traumatic brain injury says the Rand study confirms research the military has done. But she is concerned about the allegation of inadequate care. 
 
“Clearly, that's a finding that concerns us,” said Colonel Sutton. “It's very consistent with the civilian literature, as well as with our own assessment of the challenges in this area. Closing that gap between knowledge and practice is really one of our very top priorities.” 
 
Colonel Sutton says the Rand study confirms that part of the problem is that some soldiers, sailors, airmen and marines are reluctant to seek treatment, in part because of fear it will affect their security clearances and their future careers. Her office is trying to spread the word that symptoms of stress are normal, and seeking treatment is a sign of strength, not weakness. 
 
“For the folks who experience post-traumatic stress, that's a much larger number of folks than actually develop the disorder,” said Sutton. “And so part of our challenge is to help families help individuals, warriors, help communities understand what are the normal reactions, the human responses, to stress.” 
 
The colonel, who is a psychiatrist, says the issue of traumatic brain injury from explosions and accidents is somewhat different. She says most concussions are minor, and resolve themselves naturally over a fairly short period of time. 
 
The Rand study's co-leader, Terri Tanielian, agrees, and says while some brain injuries are clearly serious and have long-term consequences, some combat veterans may think they are suffering the aftereffects of such an injury when they are not. 
 
“There are a significant number of service members that may be concerned about that exposure and attributing problems or difficulties that they're having today with that brain injury, even though, based on the civilian literature, the majority of those cases are likely to be very mild forms, such as concussions, and that most of the symptoms associated with that type of injury would have resolved by now,” said Tanielian. 
 
The researcher calls for more extensive screening and treatment to ensure brain injuries and mental disorders are properly diagnosed and treated, but she also acknowledges there is a nationwide shortage of people qualified to do that. 
 
The military has said mental health problems are particularly acute among troops assigned to long and multiple deployments to war zones, as many U.S. combat brigades have been. Colonel Sutton says the military has hired or contracted with thousands of practitioners to prepare for the return of tens of thousands of troops from Iraq in the coming months as the surge of U.S. forces ends.