• Post-traumatic stress syndrome has increased among veterans from long-ago conflicts. In 2013, 62,536 new cases of PTSD were diagnosed in veterans who did not serve in the Iraq and Afghanistan wars.
• Veterans of the Iraq and Afghanistan wars use Veterans Affairs services at rates double those of other veterans: 54 percent versus 27 percent for all veterans.
• PTSD is the third most common major service-connected disability after hearing loss and ringing of the ears.
— Associated Press
The Institute of Medicine is an independent group of experts that advises the federal government on medical issues. Its recommendations often make their way into laws drafted by Congress and policies implemented by federal agencies.
Only about half of the veterans diagnosed with post-traumatic stress syndrome last year after serving in Iraq and Afghanistan received the recommended therapy despite efforts by the Department of Veterans Affairs to beef up its mental health staffing, the Institute of Medicine said in a report released Friday.
About 53 percent of the veterans whose primary diagnosis was PTSD got at least eight psychotherapy sessions within a 14-week period in 2013. But that is significantly short of the department’s target of 67 percent, according to the report.
The Institute of Medicine, an independent agency that advises the federal government, also found issues with the way active members of the military dealing with PTSD are treated. It described the Department of Defense’s treatment programs as “ad hoc, incremental, and crisis-driven, with little planning devoted to the development of a long-range approach to obtaining desired outcomes.”
Together, the VA and Defense Department spent nearly $3.3 billion in 2012 to treat patients with PTSD. And while both are making strides to identify and treat people with PTSD, many obstacles remain before they will have an “integrated and higher-performing” system, the report said.
One of the biggest problems is a lack of data to measure which treatments patients are receiving and whether the patients are getting better, said the study’s chairman, Sandro Galea of the Mailman School of Public Health at Columbia University.
“Given that the DOD and VA are responsible for serving millions of service members, families, and veterans, we found it surprising that no PTSD outcome measures are used consistently to know if these treatments are working or not,” Galea said. “They could be highly effective, but we won’t know unless outcomes are tracked and evaluated.”
Galea said tracking does occur with veterans participating in a specific VA program that involves intensive therapy, but that program serves only 1 percent of veterans who have PTSD, and the data suggest the program yields only modest improvement in symptoms.
The VA has come under fire recently because of the troubles some new patients have had getting access to care. The IOM’s study has been taking place for years, however. The first phase of study, released in 2012, recommended that soldiers returning from Iraq and Afghanistan undergo annual screening for PTSD and that federal agencies conduct more research into which treatments were working.
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