Follow-Up Exams Uncover More Iraq Vets With Emotional Woes

Follow-Up Exams Uncover More Iraq Vets With Emotional Woes
TUESDAY, Nov. 13 (HealthDay News) -- The number of Iraq warveterans needing mental-health care has risen sharply since the U.S.Defense Department began screening them a second time for emotionalproblems, U.S. military researchers reported Tuesday.
Initial screenings of veterans uncovered 4.4 percent who neededtreatment for problems such as depression or post-traumatic stressdisorder (PTSD). But six months later, a second screening found 11.7percent were in need of mental health care, indicating that it might takeseveral months for emotional disorders to emerge, the study suggested.
"We know mental health problems are a problem for soldiers who havebeen to war," said lead researcher Dr. Charles S. Milliken, of the WalterReed Army Institute of Research at the U.S. Army Medical Research andMateriel Command. "We are doing a good thing by having erected thesescreening programs. Between the two screenings, we are finding a largegroup of soldiers that are having problems."
The findings are published in the Nov. 14 issue of the Journal ofthe American Medical Association.
For the study, Milliken and his colleagues collected data on the mentalhealth of 88,235 Iraq war veterans who completed an initial screening anda second screening about six months later. Both screenings included aquestionnaire and a short interview with a clinician.
"In the second screening, you do find a larger group of soldiers thefirst screening completely missed," Milliken said. "It's about twice asbig."
The researchers found that more soldiers had mental health problems --such as PTSD, major depression or alcohol abuse -- during the laterscreening. In the first screening, 4.4 percent of the soldiers werereferred for mental health care, but, after the second screening, 11.7percent were referred.
Milliken thinks the two-step screening process helps remove the stigmaattached to seeking help for emotional problems. "Soldiers are like otheryoung males, they have a stigma about seeking mental health care," hesaid.
Among all the soldiers screened, 20.3 percent of active duty personnelwere referred for mental health care, as were 42.4 percent of reservesoldiers, the study found.
Milliken said he didn't know why the difference exists between theactive duty soldiers and the reservists. He speculated, however, that itmight have to do with the VA's insurance structure that allows reservistsaccess to free care for service-related health problems.
One expert thinks the new, two-tier system for identifying soldierswith emotional problems is working, but the shear numbers of affectedveterans could overburden the VA's health-care system.
"I am not surprised by the rates of PTSD among Iraqi vets," said Dr.Randall Marshall, director of Trauma Studies at the New York StatePsychiatric Institute and an associate professor of clinical psychiatry atColumbia University College of Physicians and Surgeons.
Marshall said the difference in PTSD rates among active duty andreserve personnel is expected. "Part of what training is meant to do isdesensitize soldiers to all the potential experiences on the battlefield,and the reservists have less training and are therefore more vulnerable towar experiences," he said.
Marshall also said that many reservists have had several tours of duty,"which is something they had not signed up for."
Also, many of these part-time soldiers were split from their units,which means they didn't have as much of a support system as active dutypersonnel, he said.
Marshall sees another major problem developing for returning veterans.Most psychotherapists aren't trained in the best ways to treat PTSD, hesaid. "You can't assume because it's a VA hospital everyone there has hadthis kind of training," he said.
In addition, the number of soldiers needing mental health care isstraining an already overburdened system.
"If 20 percent of the veterans realize they need help and start to seektreatment, the system will be overwhelmed. Signs are, it already is,"Marshall said.
More information
To learn more, visit the U.S.Department of Veterans Affairs.