January 26, 2011
Military veterans from New York state who served in Iraq and Afghanistan are at high risk for mental health problems, according to a new study conducted by the RAND Corporation and funded by the New York State Health Foundation.
Nearly a quarter of veterans (22 percent) in New York state were found to have a probable diagnosis of post-traumatic stress disorder and/or major depression. Compared to similar individuals in the general population, the veterans studied were at an eight-fold greater risk of probable PTSD and a two- to four-fold greater risk of major depression.
While many services are available to those in need, more than 40 percent of veterans report being unaware of what help is available or uncertain about how to navigate the systems that provide assistance. Outreach to connect veterans with services and better coordination among government and community agencies is needed, according to the study, which is the first to look at the needs of returning veterans and their families in New York state.
"This study underscores that many returning veterans have mental health needs that require substantial attention from both the Department of Veterans Affairs and other service providers in New York state," said Terry Schell, the study's lead author and a senior social scientist at RAND, a nonprofit research organization. "While many services are available, more needs to be done to make sure veterans get the help they need."
Since October 2001, approximately 2 million U.S. troops have been deployed to Iraq and Afghanistan, and an estimated 85,000 of the troops have returned to New York. Previous national research by RAND has shown that returning veterans are at high risk for mental health disorders and other types of impairments following deployment.
"Veterans who have served our country deserve a health system that is easy to understand and easy to access," said James R. Knickman, president and CEO of the New York State Health Foundation. "This study helps us to understand where there are gaps in services. It should be a priority for the Veterans Administration to improve outreach and coordination of services for all veterans in need."
The study found that 26 percent of veterans were unsure how to get answers for their questions about treatment. In addition, almost half of the veterans surveyed indicated that they prefer to receive services in the community rather than through the VA system.
In contrast to the high rates of PTSD and depression among veterans, the rate of veterans' illicit drug use was lower than in the general population, and alcohol misuse was similar to the rate found among comparable individuals in the general population. However, a considerable number of veterans misuse alcohol and might benefit from treatment, according to researchers.
The study also assessed the needs of veterans' spouses. Spouses reported experiencing several challenges after their veterans return from deployment. Nearly half reported problems dealing with their veteran spouse's mood changes and 42 percent were worried about the possibility of future military deployments.
RAND researchers say one clear finding from the study is that veterans' health and well-being are the responsibility of more than just the Department of Veterans Affairs. Veterans are frequently using providers from government-run programs other than the VA and from the civilian health care system.
"The needs of veterans are not addressed solely through the VA," said study co-author Terri Tanielian, co-director of the RAND Center for Military Health Policy Research. "Veterans need services that may be better accessed through private providers, non-profit organizations or public health programs. These different systems must work together with the VA to provide veterans access to high-quality, coordinated care."
Researchers recommend more effort be put into connecting veterans with care coordinators who can provide personalized assistance across a range of service sectors. The existing system often misses the veterans most in need of outreach—those who have not yet enrolled in the Veterans Health Administration.
The study focused on people living in New York state who deployed overseas, then returned to the community. Unlike most other studies of veterans, RAND researchers drew from all veterans across the state, not just those receiving services from the Department of Veterans Affairs.
Researchers surveyed 913 veterans and 293 spouses of veterans from New York, and conducted six focus groups of veterans and their family members across the state. In addition, they documented services for veterans that are currently available in New York state.
The report, "A Needs Assessment of New York State Veterans: Final Report to the New York State Health Foundation," can be found at www.rand.org. The study is part of the New York State Health Foundation's Initiative for Returning Veterans and Their Families, which aims to advance solutions to address the needs of Iraq and Afghanistan veterans and their families.
RAND Health, a division of the RAND Corporation, is the nation's largest independent health policy research program, with a broad research portfolio that focuses on quality, costs and health services delivery, among other topics.