The Army has stepped up mental health screening at the end of tours, but the Rand study says many soldiers are still undiagnosed. Less than half of the 300,000 affected veterans have been treated.
By Julian E. Barnes, Los Angeles Times Staff Writer

WASHINGTON -- Nearly one in five veterans of the Iraq and Afghanistan wars is currently suffering from depression or stress disorders, according to the latest and most comprehensive study of current and former military service members, released today.

Less than half of those 300,000 veterans have received care for depression or post traumatic stress disorder (PTSD), according to the study, signaling significant problems with the U.S. mental healthcare system. 

The study shows that the stress disorders may be more prevalent and lasting than previously known. Although the Army has conducted annual evaluations of troops deployed in Iraq, the new study, conducted by the Rand Corp. and funded by the California Community Foundation, is the first to try and assess the mental health of the 1.65 million service members that have been deployed to Iraq or Afghanistan...

Amid reports of increased mental health problems, the Army has been dramatically stepping up its screening of soldiers at the end of their tours.

But the Rand study argues many soldiers and Marines are still slipping through the cracks in the bureaucratic system. The symptoms of depression and PTSD can appear months after an incident, and so mental problems that appear later may never be caught, the study said.

Based on interviews with 1,965 current and former service members, the study asked how many had suffered from PTSD within the previous 30 days and suffered from depression within the previous two weeks.

"We have tried to generate this estimate across the entire deployed population," said Terri Tanielian, one of the study's authors. "We are looking at the scope of the problem now among the population back in the United States."

The study also shows that 19.5% of veterans had received a concussion or other traumatic brain injury during their combat tour, a number similar to Army estimates.

Some service members may actively avoid a diagnosis of a mental health problem, fearing the negative consequences of being diagnosed with a stress disorder or depression, according to the study. These troops are worried that their career could be hurt or co-workers would have less confidence in them after a diagnosis.

"When we asked folks what was limiting them from getting the help that they need, among the top barriers that were reported were really negative career repercussions," Tanielian said.

The report recommends finding ways to allow service members to get mental healthcare "off the record" so that they would not have to disclose it to superior officers, unless it was those officers who referred the service member for help.

Since some soldiers and Marines fear that seeking treatment will prevent them from being redeployed with their unit, the study authors also recommend not basing fitness-for-duty reports on whether a service member has sought mental healthcare.

Those service members who want treatment face a dearth of healthcare providers with expertise in treating war-related mental disorders, the study found. The shortage leads to long wait times that discourage some people from getting help.

Thousands more mental health professionals -- both in government hospitals and the civilian healthcare systems -- are needed to meet the need of troops and veterans, and new training is needed for current medical professionals, according to the report.

"Since the dramatic increase in the need for services exists now, the required expansion in trained providers is already several years overdue," the report said.

The study recommends finding ways to help Iraq and Afghanistan veterans get access to the civilian mental health providers.

Mental healthcare also needs to be standardized and improved, and only a little more than half of the service members being treated for stress disorders and depressions received adequate care, according to the survey.

"The prevalence of PTSD and major depression will likely remain high unless greater efforts are made to enhance systems of care for these individuals," the report said.

Stress disorders and other combat-related mental ailments can lead to suicide, homelessness and physical health problems. But more mundane problems caused by stress disorders and depression can have long-term social consequences.

"These conditions can impair relationships, disrupt marriages, aggravate the difficulties of parenting, and cause problems in children that may extend the consequences of combat trauma across generations," the study says.

The failure to adequately treat depression and stress disorders can cost the United States up to $6.2 billion, said Lisa H. Jaycox, another of the study's authors.

"While the existing therapies do not guarantee recovery in 100% of people," Jaycox said, "we make the case that investing in treatment early would prevent some of the negative consequences from unfolding and save money."

 

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