Providing Best Mental Health Treatments for All Veterans Could Save Money as Well as Lives
Growing numbers of U.S. veterans return with post-traumatic stress disorder (PTSD) and major depression, but there is some encouraging news: Providing high-quality treatments to all veterans with these conditions could generate substantial social cost savings, according to a RAND study published in the journal Psychological Trauma: Theory, Research, Practice, and Policy.
“From a societal perspective, evidence-based treatment would pay for itself in two years.”
In the study, researchers predicted that more than 22 percent of the servicemembers who were deployed in support of Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF) on June 30, 2008, would suffer from PTSD or major depression within two years of returning home. Of those with the disorders, just slightly more than half would be treated within these two years, and only 30 percent of those treated would receive evidence-based treatments (treatments that research has demonstrated promote recovery). The resulting social costs (which include treatment costs, lost productivity, and the costs associated with lives lost to suicide) would be $923 million (see the figure). These estimates of treatments and costs reflect standard practices in 2008.
But what if all veterans suffering from PTSD or major depression would immediately receive the recommended treatments in the first three months of onset? Researchers found that although the cost of treatment would be higher, the total two-year social costs would be only $785 million — for a savings of $138 million, or 15 percent (the lower bar in the figure).
Immediately Giving Recommended Treatments to All Veterans with PTSD or Major Depression Could Cut Costs 15 Percent in Two Years
SOURCE: “Invisible Wounds, Visible Savings? Using Microsimulation to Estimate the Costs and Savings Associated with Providing Evidence-Based Treatment for PTSD and Depression to Veterans of Operation Enduring Freedom and Operation Iraqi Freedom,” Psychological Trauma: Theory, Research, Practice, and Policy, Vol. 3, No. 2, June 2011, pp. 201–211, Beau Kilmer, Christine Eibner, Jeanne S. Ringel, Rosalie Liccardo Pacula.
NOTE: Results for the scenarios are based on 50 simulations.
“The findings suggest that, from a societal perspective, evidence-based treatment for PTSD and major depression would pay for itself in two years,” said Beau Kilmer, a RAND senior policy researcher who led the study. “Although evidence-based care costs more than the treatment usually provided to veterans, it increases the probability of recovering from mental illness, which ultimately increases productivity and reduces the risk of suicide.”
These estimated benefits of evidence-based treatment are likely to be conservative because they focus on only the two years after return and do not consider the potential costs from other consequences of PTSD and major depression, such as substance use, domestic violence, and homelessness.
The future health-related costs for the more than 2.25 million U.S. troops who have deployed to OEF and OIF will undoubtedly be high because of physical and mental health injuries. “But we can mitigate those costs and reduce suffering at the same time by providing high-quality behavioral health care for all veterans who need it,” said Kilmer. 
RAND® is a registered trademark. Copyright © 1994-2013 RAND Corporation.