Giving Compass' Take:

• RAND Corporations reveal how research around effectively addressing the mental health consequences of war led to conversations and policy changes around PTSD and depression in veterans. 

• How can funders help to build upon the success of this undertaking? 

• Learn about an app connecting veterans to talk about mental health. 

Exposure to traumatic stress has always been a part of combat. In Iraq and Afghanistan, however, advances in combat medicine and body armor meant that the lives of wounded soldiers that would likely have been lost in previous conflicts were instead being saved—though with significant physical, emotional, and cognitive impairments. In 2007, concerns about PTSD and TBI were sparking media attention and additional health assessments of service members.

The California Community Foundation sponsored a study by RAND to fill these information gaps for PTSD, major depression, and TBI. RAND assembled a team of over 30 experts in psychology, economics, public health, and related fields to review scientific research, survey service members and veterans, assess systems of care, and develop an econometric model to estimate costs. The study was the first of its kind to take a comprehensive view from a societal perspective.

Findings:

  • In 2007, 18.5 percent of U.S. service members who had returned from Iraq or Afghanistan had PTSD or depression, and 19 percent had reported experiencing a TBI while deployed.
  • There are significant short- and long-term cascading consequences associated with these disorders. The two-year post-deployment costs of PTSD and depression are significant, as high as $6.2 billion; however, providing high quality, evidence-based treatment to everyone with these conditions would save money or pay for itself within the same time frame.
  • Roughly half of those who needed treatment for those conditions sought it, but only slightly more than half of those receiving it were getting even minimally adequate care. Service members reported barriers to seeking care including concerns about negative career repercussions.

Recommendations:

  • Increase the cadre of providers who are certified to deliver evidence-based care, so that capacity is adequate for needs.
  • Change policies to encourage more active-duty personnel and veterans to seek needed care.
  • Deliver proven, evidence-based care to service members and veterans.

Within weeks of the release, DoD announced changes to its applications for security clearance to exempt service members from reporting that they had received combat- or family-related counseling from a mental health professional. RAND had reported that acknowledging such treatment had been perceived by service members as having negative career consequences.

The findings galvanized citizens and policy makers, and led to large psychological and cognitive health projects funded by the DoD both at RAND and elsewhere.

Read the full article about addressing the mental health consequences of war at RAND Corporation.