Mental Illness Among U.S. Veterans

Almost a third of veterans from the war in Iraq and Afghanistan have been diagnosed with a psychosocial or mental health illness, reports a new study.

Researchers from the University of California, San Francisco and Health Service s Research and Development Research Enhancement Award Program and the San Francisco VA Medical Center studied mental health disorders among 103,788 U.S. veterans who returned from Iraq and Afghanistan.

According to the study, veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) have endured high combat stress and are eligible for two years of free military service-related health care through the Department of Veterans Affairs (VA) health care system, yet little is known about the burden and clinical circumstances of mental health diagnoses among OEF/OIF veterans seen at VA facilities. 

The study included U.S. veterans separated from OEF/OIF military service and first seen at VA health care facilities between September 30, 2001 (U.S. invasion of Afghanistan), and September 30, 2005. Mental health diagnoses and psychosocial problems were assessed using International Classification of Diseases, Ninth Revision, Clinical Modification codes.

Researchers found that out of 103,788 OEF/OIF veterans seen at VA health care facilities, 25,658 or 25 percent received mental health diagnosis(es); 56 percent of whom had two or more distinct mental health diagnoses. Overall, 32,010 or 31 percent received mental health and/or psychosocial diagnoses.

Mental health diagnoses were detected soon after the first VA clinic visit (average of 13 days), and 60 percent of initial mental health diagnoses were made in non-mental health clinics, mostly in primary care settings. The youngest group of OEF/OIF veterans, aged 18-24 years, were at greatest risk of receiving mental health or posttraumatic stress disorder diagnoses compared with veterans 40 years or older. 

Researchers concluded that co-occurring mental health diagnoses and psychosocial problems were detected early and in primary care medical settings in a substantial proportion of OEF/OIF veterans seen at VA facilities. Researchers recommended targeted early detection and intervention beginning in primary care settings to prevent chronic mental illness and disability. 

Alternative treatments for mental illnesses with good scientific evidence include hypnotherapy, hypnosis, music therapy, psychotherapy and yoga.

Comments

[J.Kathryn Bryan]

I am glad that the military is addressing the issue of mental illness among veterans. During wartime, our troops face stressful and emotional situations, as they put their lives on the line for our country. Most of the people in my life who have faced combat situations are able to return to a relatively normal life after a tour of duty. However, that isn’t to say that the psychological trauma of war hasn’t had any impact on their civilian lives.

Does the United States military really provide adequate healthcare services to assure the emotional and psychosocial well-being of our troops once they’ve returned home? Psychological care during combat focuses on returning the troops to action. I think that this approach may cause some troops, including those I have known, to experience lingering illnesses long after immersion back into civilian life.

A quick debrief may not be enough to ensure that our troops are emotionally stable and psychologically healthy. I think that the trauma of war may follow many veterans home, even as normal life resumes. While none of the veterans in my life really seem to be ill enough to be diagnosed with a mental illness, I see the difficulty of battles long since passed continue to haunt them in nightmares, flashbacks and even bodily aches of no origin. I hope that the military keeps the mental health needs of these veterans in mind.

[Dexter Otis Grenne]

I am a little concerned that "little is known about the burden and clinical circumstances of mental health diagnoses among OEF/OIF veterans seen at VA facilities." I would have assumed people studied the effects of war on surviving soldiers minds since the beginning of psychology. I am sure it has changed since WW1, when real war machines began to emerge and even more so during Korea/Vietnam when civilians really began to die in large numbers as a direct result of the actions of military personnel from all sides. This sort of thing can haunt a soldier for the rest of their lives, but it's nothing new to the Iraq/Afghani wars. The data are there from the previous wars. VA doctors know what will happen to a large number of soldiers' minds when they come home. What they need to be testing are ways to try to alleviate the mental anguish they experienced during and after the war. Unfortunately, in my opinion, this will prove to be impossible.

[Anonymous]

Honestly, I give them credit for being tough and hanging in there, both physically and mentally, and being able to return home safely. For those that were diagnosed with PTSD, there are treatments available that I think would be beneficial, as there are FDA-approved medications currently out on the market. Namely, the SSRIs could be used. On top of that, I think counseling, as well as alternative therapies such as meditation, could improve their symptoms.

[D Meyer]

RE: J. Kathryn Bryan's about the adequacy of mental healthcare for returning veteran's of war - I recently wrote a report on this topic and was saddened to learn that the level of care for VAs with PTSD or other mental health issues is poor. Soldiers needing help face protracted delays in receiving outpatient or inpatient care and often get the short shrift when it comes to diagnosis and treatment. Further complicating the issue is the stigmatization of mental illness within the military that discourages vets from seeking treatment at all.

Much was learned about PTSD and other combat-related mental disorders during the Vietam era and the need to identify and treat it. Little, if any, of this is being put into practice today. At the very least, studies such as this keep the issue on everyone's "radar map." With what promises to be a long, drawn out conflict in Iraq, this country will be dealing with a growing number of veterans suffering from combat-related mental disorders... it would be egregious not to be prepared to help them deal with it effectively.

[Cady]

I agree that there are adequate options for therapy for our veterans. The problem lies in making sure they receive that therapy. Many may not believe the therapy is even necessary. I know a few men who have returned from Iraq changed. The person they used to be has been tainted by the violence that they witnessed. I do give them an enormous amount of credit for doing all that they did, so now it is our turn to ensure they are taken care of when they come home.

[Rachelle Provost]

This reminds me of the whole Walter Reed scandal. Also, this is going to make me sound ridiculous, but there was a recent episode of ER that featured a young man who was a translator in Iraq who had PTSD and was not getting any treatment for it at the VA Center he was originally in, and so he was trying to fake pain just to be given painkillers to ease his grief. I think it's tragic and absolutely unacceptable that we disrespect these soldiers by not giving them adequate healthcare upon their return from war. The government is responsible for putting them in danger's way, and it should take responsibility for the wounds our vets suffer as a result. Instead, I cringe to think of all of the men and women who have suffered alone because no one cared.

[Emily P.]

Having family members who fought in Vietnam, I’ve seen first hand the mental effects war can have on a person. It’s difficult to say exactly how they were effected, considering one passed away in the war, and the other refused to speak about his experience, but it was obvious he was haunted by it for the rest of his life. I’m worried about the future of our youth in Iraq and the families they have left behind, as there are so few resources available to them once they return home.

[MV]

Early intervention is critical to the health of these veterans, and I hope the government and healthcare providers can help remove the stigma around receiving psychiatric services. I watched a special on T.V. about a veteran from Iraq that suffered extensive brain damage and had difficulty getting the best care here in the U.S. It was sad to see that the government did not take a more proactive approach in helping these soldiers after they returned from war.

[Paul]

So, its pretty well agreed that this is a huge problem to deal with. The one thing I am really concerned about is what happens when their two years of free care are up? Is this something that is a semi-acute issue due to combat and then resolves (doubtful), or is this something that then becomes a burden on the rest of society as these people who fought and did everything asked of them are then dropped out of the VA system with no where to go? This research shows that the problem is real and widespread. Now we need to figure out how to help those who need it.