Post-War Stress Takes a Long-Term Toll

According to a new study conducted by the RAND Corporation, more than 300,000 US troops are suffering from major depression or post-traumatic stress disorder (PTSD) after serving in the wars in Iraq and Afghanistan, and 320,000 of them received brain injuries. Only about half of the sufferers have sought treatment.

“There is a major health crisis facing those men and women who have served our nation in Iraq and Afghanistan,” says RAND researcher, Terri Tanielian. RAND is a non-profit organization focused on issues of national security.

The 500-page study is the first large-scale, private assessment of its kind—including a survey of 1,965 service members across the country—from all branches of the armed forces and including those still in the military, as well veterans who have left the services. In fact, the study results are consistent with a number of mental health reports from within the government. Department of Veterans Affairs said this month that its records show about 120,000 of former serviceman and women who served in the two wars and are no longer in the military have been diagnosed with mental health problems; of this number, approximately 60,000 are suffering from PTSD.

Veterans Affairs is responsible for care of service members after they have left the service, while the Defense Department covers active-duty and reservist needs. The lack of information from the Pentagon was one motivation for the RAND study, says Tanielian.

US Army officials found that 18.2 percent of soldiers suffered a mental health problem, such as depression, anxiety or acute stress in 2007 compared with 20.5 percent the previous year.

The Rand study, completed in January, put the percentage of PTSD and depression at 18.5 percent, calculating that approximately 300,000 current and former service members were suffering from those problems.

RAND researchers also found:

• About 19 percent—or some 320,000 services members—reported that they experienced a possible traumatic brain injury while deployed. In wars where blasts from roadside bombs are prevalent, the injuries can range from mild concussions to severe head wounds.
• About 7 percent reported both a probable brain injury and current PTSD or major depression.
• Only 43 percent reported ever being evaluated by a physician for their head injuries.
• Only 53 percent of service members with PTSD or depression sought help over the past year.
• They gave various reasons for not getting help, including that they worried about the side effects of medication; believe family and friends could help them with the problem; or that they feared seeking care might damage their careers.

Data collection for this study began in April 2007 and concluded in January 2008. Specific activities included a critical review of the extant literature on the prevalence of post-traumatic stress disorder, major depression, and traumatic brain injury and their short- and long-term consequences.

RAND recommends effective treatments, citing delivery of such care to all veterans with PTSD or major depression would pay for itself within two years by improving productivity and reducing medical and mortality costs. However, such involved planning requires system-level changes across the Department of Defense, the Department of Veterans Affairs, and the US healthcare system. Is the US ready for such a dedicated overhaul?