Veterans as a public health issue...

FROM: Kaiser Daily Health Policy Report (7/17/09)
PUBLIC HEALTH & EDUCATION
11. Mental Health Issues Among Veterans Increase Dramatically [Jul 17, 2009]
A new study finds more veterans being diagnosed with mental health issues. The study was posted Thursday on the web site of The American Journal of Public Health. The New York Times reports: "A new study has found that more than one-third of Iraq and Afghanistan war veterans who enrolled in the veteran’s health system after 2001 received a diagnosis of a mental health problem, most often post-traumatic stress disorder or depression. The study by researchers at the San Francisco Department of Veterans Affairs Medical Center and the University of California, San Francisco, also found that the number of veterans found to have mental health problems rose steadily the longer they were out of the service. The study, released Thursday, was based on the department health records of 289,328 veterans involved in the two wars who used the veterans health system for the first time from April 1, 2002, to April 1, 2008." The Times reports: "The researchers found that 37 percent of those people received mental health diagnoses. Of those, the diagnosis for 22 percent was post-traumatic stress disorder, or PTSD, for 17 percent it was depression and for 7 percent it was alcohol abuse. One-third of the people with mental health diagnoses had three or more problems, the study found. The increase in diagnoses accelerated after the invasion of Iraq in 2003, the researchers found. Among the group of veterans who enrolled in veteran’ s health services during the first three months of 2004, 14.6 percent received mental health diagnoses after one year. But after four years, the number had nearly doubled, to 27.5 percent. The study's principal author, Dr. Karen H. Seal, attributed the rising number of diagnoses to several factors: repeat deployments; the perilous and confusing nature of war in Iraq and Afghanistan, where there are no defined front lines; growing public awareness of PTSD; unsteady public support for the wars; and reduced troop morale" (Dao, 7/16). Forbes reports: "Curiously, the researchers from the San Francisco VA Medical Center found that most mental health diagnoses were not made in the first year that a veteran entered the VA health-care system, but several years after. This finding supports the recent move to extend VA benefits to five years of free health care, which allows VA doctors the time to detect and treat more mental illness in returning combat veterans, the researchers noted." Forbes notes: "Women had a higher risk for depression, but men had more than twice the risk for drug use problems, the researchers found. Since the start of the Iraq war, mental health problems increased more than fourfold among active-duty personnel and sevenfold for members of the National Guard or Reserve, [lead researcher Dr. Karen] Seal said. Age also played a role in the risk for PTSD, Seal said. While younger active-duty veterans had a higher risk for PTSD, 'among Guard and Reserve members, those over 40 were at significantly higher risk for PTSD than their colleagues under 25,' she said. Moreover, active-duty enlisted veterans in the Army rather than other service branches, or who had multiple tours of duty, thus more combat exposure, were at greater risk for PTSD, Seal said. This was not seen in National Guard and Reserve personnel, she noted" (7/16). Bloomberg reports on the study noting: "The high number of mental health disorders puts the U.S. at risk of 'an epidemic of chronic mental illness, as occurred with Vietnam veterans,' the study's authors wrote. A study published in 1990, Trauma and the Vietnam War Generation, found almost 1 million men, or about 31 percent of the soldiers who served in Vietnam, were diagnosed with post- traumatic stress disorder. More than one-fourth had symptoms of the illness up to 20 years after their active-duty service" (Olmos, 7/17). The Los Angeles Times reports: "The newest study correlates closely to a 2008 report by the Rand Corp., based on a much smaller sample of Iraq and Afghanistan veterans. In that study, about 14% met the criteria for PTSD and 14% for depression" (Chong, 7/16).