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VA diagnosing higher rates of PTSD
By William H. McMichael - Staff writer http://www.airforcetimes.com/news/2009/01/military_veterans_carestats_011609w/
Posted : Friday Jan 16, 2009 16:18:25 EST
More than 44 percent of Iraq and Afghanistan war veterans who have sought treatment at a Department of Veterans Affairs medical facility have been diagnosed with one or more possible mental disorders, according to the agency’s most recent summary of veteran health care.
All told, a total of 178,483 veterans who came to VA for help were diagnosed with possible mental disorders from fiscal 2002 through September 2008, according to the January report of the VHA Office of Public Health and Environmental Hazards.
Of that total, 92,998 service members, or 23 percent, were diagnosed with possible post-traumatic stress disorder, while 63,009, or 16 percent, were found to have possible depressive disorders.
The VA figures overlap to an unknown extent because officials say a veteran may have been diagnosed with more than one disorder.
In addition, the total of those who have come to VA for health care is a limited sample of the 1.7 million service members who have served in the two wars — as of Sept. 30, 2008, 400,304 war veterans had sought such treatment over the past seven years, or about 24 percent of the totals number of troops who have served in the conflicts.
Because the service members seeking treatment were not randomly selected and are less than one-quarter of the total population of veterans of the wars, VA cautions that they are not a true representative sample.
VA also says that up to one-third of its diagnoses might not have been confirmed because they were provisional pending further evaluation, and that revising records is a resource-intensive effort rarely done in the public or private sector.
At the same time, the number of VA’s possible diagnoses of PTSD has risen “quite steadily” over the past seven years. And, said Antonette Zeiss, VA’s deputy director for mental health services, “there’s a steeper rate of increase between each of the quarterly reports as time goes on.”
In addition, the 23 percent of veterans seen by VA who were initially diagnosed with PTSD, Zeiss agreed, is generally in line with outside estimates.
In an April study by the Rand Corp., nearly 20 percent of Iraq and Afghanistan veterans surveyed reported symptoms of PTSD or major depression. Many of those who have served in the wars, Rand noted, have been exposed to prolonged periods of combat-related stress or traumatic events.
Rand also found that many service members say they don’t seek treatment for psychological illnesses because they fear the repercussions will harm their careers. “We know there are guys who desperately need help who aren’t coming to us,” said Phil Budahn, a VA spokesman.
And even among those who do seek help for PTSD or major depression, Rand found, only about half receive treatment that researchers consider “minimally adequate” for their illnesses.
Rand concluded that a “major national effort is needed to expand and improve the capacity of the mental health system to provide effective care to service members and veterans.”
Anumber of causes could be behind the increase in VA diagnoses, Zeiss said: multiple and prolonged deployments to the wars; better screening by VA; efforts by VA and the military to destigmatize PTSD; and veterans possibly choosing VA care over other options.
Other possible mental health diagnoses of returning vets, according to the VA report, were neurotic disorders (50,569 veterans), affective psychoses (35,937), non-dependent abuse of drugs (27,246) and alcohol dependence syndrome (16,217).
VA notes that while the diagnoses are of war veterans, it cannot be certain that all of the conditions are war-related.
But, said Zeiss, “most of these conditions would not have been present prior to being in the military. In VA, we assume that these are veterans coming to us who have had significant stresses as a result of their involvement with the military and in war. And we want to treat them and respect that there’s a possibility that these are due to their experience in the military.”
Despite that and the other caveats, Zeiss said the diagnoses statistics “tell us what level of demand for services there is likely to be.”
Since the number of VA’s PTSD diagnoses is on the rise — and, she noted, represent only about half of all mental health disorder diagnoses — “we also need to sustain an overall mental health system that can treat the whole range of mental problems.”
The figures, she said, also support a VA decision made three years ago to start training mental health providers to be able to provide the strongest evidence-based treatments for PTSD, such as cognitive processing therapy and prolonged exposure therapy, and application of medications for PTSD symptoms.
Overall, possible mental health disorders ranked slightly behind disorders of the joints and back; VA said that about 49 percent of those veterans of the wars in Iraq and Afghanistan were diagnosed with possible musculoskeletal problems.
A category called “symptoms, signs and ill-defined conditions” — a collection of mostly normal symptoms that don’t have an immediate, obvious cause during a clinic visit — was third on the list, with 42 percent of veterans seeking VA health care receiving this possible diagnosis.
These were followed by diagnoses of possible diseases of the nervous system and sense organs (36.6 percent), digestive problems (32.4 percent), and diseases of the endocrine, nutritional and metabolic systems (23.2 percent).
As with the mental health diagnoses, veterans could have been diagnosed with more than one condition, VA noted.
The vast majority of the 400,304 war veterans who came to VA were seen as outpatients.
Of the roughly 1.7 million service members who have served in the two wars, 945,423 veterans have become eligible for VA health care — 483,136 active-duty troops, and 462,287 reservists. Some 209,099 and 191,205, respectively, have actually sought care at VA.
The latest VA figures represent 42 percent of the care-eligible population. Most — 88 percent — were male; 50 percent were ages 20-29; 92 percent were enlisted; 52 percent were active-duty; and the vast majority, 64 percent, were Army soldiers.
Just 13 percent of veterans who sought VA treatment were Marines, and just 12 percent were sailors and airmen, respectively.
By William H. McMichael - Staff writer http://www.airforcetimes.com/news/2009/01/military_veterans_carestats_011609w/
Posted : Friday Jan 16, 2009 16:18:25 EST
More than 44 percent of Iraq and Afghanistan war veterans who have sought treatment at a Department of Veterans Affairs medical facility have been diagnosed with one or more possible mental disorders, according to the agency’s most recent summary of veteran health care.
All told, a total of 178,483 veterans who came to VA for help were diagnosed with possible mental disorders from fiscal 2002 through September 2008, according to the January report of the VHA Office of Public Health and Environmental Hazards.
Of that total, 92,998 service members, or 23 percent, were diagnosed with possible post-traumatic stress disorder, while 63,009, or 16 percent, were found to have possible depressive disorders.
The VA figures overlap to an unknown extent because officials say a veteran may have been diagnosed with more than one disorder.
In addition, the total of those who have come to VA for health care is a limited sample of the 1.7 million service members who have served in the two wars — as of Sept. 30, 2008, 400,304 war veterans had sought such treatment over the past seven years, or about 24 percent of the totals number of troops who have served in the conflicts.
Because the service members seeking treatment were not randomly selected and are less than one-quarter of the total population of veterans of the wars, VA cautions that they are not a true representative sample.
VA also says that up to one-third of its diagnoses might not have been confirmed because they were provisional pending further evaluation, and that revising records is a resource-intensive effort rarely done in the public or private sector.
At the same time, the number of VA’s possible diagnoses of PTSD has risen “quite steadily” over the past seven years. And, said Antonette Zeiss, VA’s deputy director for mental health services, “there’s a steeper rate of increase between each of the quarterly reports as time goes on.”
In addition, the 23 percent of veterans seen by VA who were initially diagnosed with PTSD, Zeiss agreed, is generally in line with outside estimates.
In an April study by the Rand Corp., nearly 20 percent of Iraq and Afghanistan veterans surveyed reported symptoms of PTSD or major depression. Many of those who have served in the wars, Rand noted, have been exposed to prolonged periods of combat-related stress or traumatic events.
Rand also found that many service members say they don’t seek treatment for psychological illnesses because they fear the repercussions will harm their careers. “We know there are guys who desperately need help who aren’t coming to us,” said Phil Budahn, a VA spokesman.
And even among those who do seek help for PTSD or major depression, Rand found, only about half receive treatment that researchers consider “minimally adequate” for their illnesses.
Rand concluded that a “major national effort is needed to expand and improve the capacity of the mental health system to provide effective care to service members and veterans.”
Anumber of causes could be behind the increase in VA diagnoses, Zeiss said: multiple and prolonged deployments to the wars; better screening by VA; efforts by VA and the military to destigmatize PTSD; and veterans possibly choosing VA care over other options.
Other possible mental health diagnoses of returning vets, according to the VA report, were neurotic disorders (50,569 veterans), affective psychoses (35,937), non-dependent abuse of drugs (27,246) and alcohol dependence syndrome (16,217).
VA notes that while the diagnoses are of war veterans, it cannot be certain that all of the conditions are war-related.
But, said Zeiss, “most of these conditions would not have been present prior to being in the military. In VA, we assume that these are veterans coming to us who have had significant stresses as a result of their involvement with the military and in war. And we want to treat them and respect that there’s a possibility that these are due to their experience in the military.”
Despite that and the other caveats, Zeiss said the diagnoses statistics “tell us what level of demand for services there is likely to be.”
Since the number of VA’s PTSD diagnoses is on the rise — and, she noted, represent only about half of all mental health disorder diagnoses — “we also need to sustain an overall mental health system that can treat the whole range of mental problems.”
The figures, she said, also support a VA decision made three years ago to start training mental health providers to be able to provide the strongest evidence-based treatments for PTSD, such as cognitive processing therapy and prolonged exposure therapy, and application of medications for PTSD symptoms.
Overall, possible mental health disorders ranked slightly behind disorders of the joints and back; VA said that about 49 percent of those veterans of the wars in Iraq and Afghanistan were diagnosed with possible musculoskeletal problems.
A category called “symptoms, signs and ill-defined conditions” — a collection of mostly normal symptoms that don’t have an immediate, obvious cause during a clinic visit — was third on the list, with 42 percent of veterans seeking VA health care receiving this possible diagnosis.
These were followed by diagnoses of possible diseases of the nervous system and sense organs (36.6 percent), digestive problems (32.4 percent), and diseases of the endocrine, nutritional and metabolic systems (23.2 percent).
As with the mental health diagnoses, veterans could have been diagnosed with more than one condition, VA noted.
The vast majority of the 400,304 war veterans who came to VA were seen as outpatients.
Of the roughly 1.7 million service members who have served in the two wars, 945,423 veterans have become eligible for VA health care — 483,136 active-duty troops, and 462,287 reservists. Some 209,099 and 191,205, respectively, have actually sought care at VA.
The latest VA figures represent 42 percent of the care-eligible population. Most — 88 percent — were male; 50 percent were ages 20-29; 92 percent were enlisted; 52 percent were active-duty; and the vast majority, 64 percent, were Army soldiers.
Just 13 percent of veterans who sought VA treatment were Marines, and just 12 percent were sailors and airmen, respectively.
