The Critical Need for Mental Health Professionals Trained to Treat Post-Traumatic Stress Disorder and Traumatic Brain Injury

Suicide rate increasing among the active duty Army National Guard and Reserve. Even though suicides among soldiers serving on active duty decreased modestly in 2010, the number of soldiers in the Army National Guard and Reserve saw a major increase (Department of Defense, 2011).

Suicide rates increasing for returning service members. Preliminary data from the VA shows that the suicide rate for 18- to 29-year-old male veterans who have left the military rose 26 percent from 2005 to 2007, and the rate climbed to record highs by 2009 (2010).

Unemployment rate for veterans outpaces the civilian rate. Recent veterans are more likely to be unemployed than their civilian counterparts. According to data released by the Bureau of Labor Statistics in October 2011, veterans who left military service in the past decade have an unemployment rate of 11.7 percent, well above the overall jobless rate of 9.1 percent (M. Fletcher, Washington Post, Oct. 16, 2011).

Joblessness and downturn in economy may be adding to increase in suicides. Senior Army officials speculate that the increase in Guard and Reserve suicides may also be part of a broader national trend driven by elevated levels of joblessness and a bad economy (G. Jaffe, Washington Post, Jan. 19, 2011).

Veterans are returning with serious mental health issues. Of the 1.7 million veterans who served in Iraq and Afghanistan, 300,000 (20 percent) suffer from post-traumatic stress disorder or major depression (RAND Center for Military Health Policy Research, Invisible Wounds of War, 2008). The Department of Veterans Affairs also estimates that nearly 13,000 of Iraq and Afghanistan veterans have alcohol dependence syndrome (2009). In a survey of all veterans, 7.1 percent (1.8 million people) meet criteria for a substance abuse disorder (Substance Abuse and Mental Health Services Administration, 2004-2006 National Survey on Drug Use and Health, 2007).

Female veterans are particularly likely to suffer from mental health issues. According to the VA, about one-in-five female veterans have post-traumatic stress related to "military sexual trauma," a catch-all category that includes everything from sexual harassment to rape. Also, women are the fastest growing subset of the homeless-veteran population in America (J. Kitfield, National Journal, 2011).

Brain injuries linked to PTSD. According to the New England Journal of Medicine, 15 percent of Iraq soldiers had concussions or other mild traumatic brain injuries while on active duty. Notably, these soldiers were significantly more likely to have PTSD three months after their return home than soldiers without brain injuries. Of soldiers who reported an injury that caused loss of consciousness, 44 percent had PTSD three months after returning home (Hoge et al., 2008).

Many in need don’t seek help.According to the Army, only 40 percent of veterans who screen positive for serious emotional problems seek help from a mental health professional (Mental Health Advisory Team IV: Operation Iraqi Freedom, 2007). Statistics from the RAND Corporation are even worse, finding that only 30 percent of veterans with PTSD or depression seek help from the VA health system (Invisible Wounds of War, 2008).

Stigma associated with mental illness in military communities. The Army recognizes that stigma is a major barrier for veterans in need of mental health care (Mental Health Advisory Team IV, 2007). According to SAMHSA, service members frequently cite fear of personal embarrassment, disappointing comrades, losing the opportunity for career advancement, and dishonorable discharge as motivations to hide symptoms of mental illness from family, friends and colleagues (2007).

Veterans seek help outside the system.VA data indicates that 22 percent of veterans receive their mental health care outside the VA system. (2005) The percentage varies from state to state, with the rural states having the greatest percentage of veterans who get care outside the system (McClatchy Newspapers, Feb. 9, 2007).

Inaccessible mental health providers. A Department of Defense task force found that a significant number of veterans face constrained access to care when they return to their communities. In fact, one-third of both the National Guard and reservists reported choosing civilian care because they lived too far from a military treatment facility (An Achievable Vision, 2007).

Inadequately trained mental health providers. VA policy has no provision for ensuring that community mental health professionals have appropriate expertise to effectively treat veterans (Testimony by the Wounded Warrior Project in front of the Veterans Affairs Committee, 2009). Surveys also found that many veterans seeking help are not properly identified as having PTSD (Mental Health Advisory Team IV, 2007).

Long-term consequences of unaddressed mental health needs.Veterans with untreated mental health problems may face severe consequences to their overall health and ability to fully reintegrate into their communities, exacerbating the potential for chronic mental health conditions. Therefore, failure to intervene early and effectively could have profound long-term costs for the health of this generation of veterans, as well as for society (Testimony by the Wounded Warrior, 2009).