Treatment Online

300,000 Returning Troops Need Mental Health Treatment
> 4/17/2008 3:21:49 PM

Mental illness in the military has been a recurring news-media theme as our current overseas conflicts continue. As unpleasant as the issue may be, we must be thankful that ongoing coverage has brought it to the attention of the general public. More than 1.6 million men and women have already served their country in Iraq and Afghanistan, many thousands bear the physical and psychological wounds of their experience, and their number will only continue to rise. We don't yet appreciate the true scope of the problem, and a new, thorough study by the RAND Corporation gives us astronomical estimates: nearly 19% of current military personnel (320,000 individuals) have sustained major brain injuries, and 300,000 currently suffer from some form of mental illness, most commonly depression and post traumatic stress disorder.

As large as this number is, RAND statistics are not completely out of line with those of the Department of Veterans Affair. This month, the group released a statement estimating that 120,000 former service members have been diagnosed with some form of mental illness - and this number includes only those who are no longer in the military. The RAND study focused on the three most important issues to arise from the current conflict: depression, PTSD, and traumatic brain injury (TBI). By evaluating current data and surveying nearly 2,000 current servicemembers, they attempted to gague the scope of the problem, its ultimate cost, and the steps we must take to address it properly in the near future. 1/3 of all previously deployed servicemembers display signs of at least one of these variables. And an estimated 5-7% (nearly 100,000 men and women) suffer from all three.

Perhaps most significantly, just over half of those who qualified for depression or PTSD diagnosis had sought any form of treatment over the past year. And of those who reported a probable TBI, an astonishing 57% had not yet sought a physical evaluation to determine whether their fears were legitimate. The only conceivable positive aspect of the treatment rate statistics is the fact that former soldiers seem no less likely to seek help than those in the general population. Perhaps the supposed stigmas that prevent military servicemembers from seeking treatment for these problems have begun to subside.

The soldiers surveyed were also very skeptical of the efficiency of the treatment they could receive, and with good reason: RAND estimates that, even among the soldiers who suffer from these problems and seek treatment, only about half actually receive even "minimally adequate treatment."

If, at the present time, we cannot grant efficient treatment to those who seek it, dramatic changes to the current system are needed. Some of the respondents' greatest concerns revolved around the belief that treatment would not remain confidential and that it would hamper future career prospects either inside the military or in the civilian work world.

The difficulty that many returning service members encounter while attempting to reintegrate is impossible to measure. Finding steady work, supporting young families, and maintaining a state of emotional stability may prove extremely difficult. The trials of war often prove particularly difficult for reservists whose training is less intensive and who are subsequently less prepared for the experience.

What about the bottom line? Can our country afford to give these soldiers the treatment they need and deserve? RAND used economic simulation models to estimate the costs of treating these conditions in the two years after affected soldiers return home, and their numbers are considerable. The price of treatment for PTSD: $5-10,000. Major depression: $15-25,000. Mild TBI: $25-30,000. And the treatment of major brain injuries will run as high as $400,000. Again, these estimates only cover two years, and they do not even take major complicating factors into account. Domestic problems, unemployment, substance abuse, and lost productivity will certainly make prices even higher. The estimated cost to our country per year runs very quickly into the billions.

Finally, one might ask of the Rand Corporation: what can we do? The unfortunate answer for the average citizen is very little. The Department of Defense has taken encouraging steps such as the formation of a specialized center designed to address brain injury and mental illness. The treatment of major brain injury is still in the early stages of its development, so continued research is a must. The military must step up its hiring rates for mental health professionals and demonstrate that the soldiers who seek treatment will get what they need. The best thing we can do is to keep this issue in the public eye and ensure that the American people and, by extension, our elected representatives do not forget how many of our brave soldiers are touched by traumatic injury and mental illness. The best way to do that is to continue to illustrate the issue on a personal level with the stories of individuals who've returned from serving their country and need serious long-term treatment. Public outrage will force the powers-that-be to act.

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