Journal Article
Mental Health Care for Iraq and Afghanistan War Veterans
May 1, 2009
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A substantial number of the 1.7 million military servicemembers returning from the conflicts in Iraq and Afghanistan may face mental health problems. A comprehensive study conducted by RAND in 2008 found that an estimated 18.5 percent of those back from deployment reported symptoms consistent with a diagnosis of post-traumatic stress disorder (PTSD) or depression. The study also examined veterans' access to quality mental health treatment. It identified gaps in the military and veterans health care systems and opportunities for improvement. A large infusion of new funds into the Department of Defense (DoD) and the Veterans Health Administration (VHA) in recent years is supporting their continuing efforts to improve care. However, many returning veterans also seek care in community settings as they reintegrate into civilian life. As part of the Invisible Wounds of War project, a RAND team published additional results identifying key challenges to the provision of mental health care that cut across community, VHA, and DoD health care settings.
The analysis identified two barriers to mental health care access in community settings:
The analysis also found gaps in the quality of care in community settings. In particular, surveys suggested that in more than half of all cases, the treatment usually received did not meet recommended standards for care as supported by scientific evidence about what works. System-level challenges may limit the availability of evidence-based care in community settings:
To address these issues, the researchers recommend a nationwide, coordinated effort to improve care by expanding the availability of training for treatment of combat-related mental disorders, promoting the development of organizational systems and tools to monitor performance and support quality improvement in mental health care, and providing technical assistance to states and communities that are working to address veterans' mental health needs.
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