Mental Health and Cognitive Care Needs of America's Returning Veterans
(The following information is gathered from a 2008 study done through nonprofit global think tank RAND. A link to the study follows this synopsis.)
Unless treated, PTSD, depression, and medical conditions can have far-reaching and damaging consequences. Individuals afflicted with these conditions face higher risks for other psychological problems and for attempting suicide. They have higher rates of unhealthy behaviors — such as smoking, overeating, and unsafe sex — and higher rates of physical health problems and mortality. Individuals with these conditions also tend to miss more work or report being less productive.
These conditions can impair relationships, disrupt marriages, aggravate the difficulties of parenting, and cause problems in children that may extend the consequences of combat trauma across generations. There is also a possible link between these conditions and homelessness. The damaging consequences from lack of treatment or under treatment suggest that those afflicted, as well as society at large, stand to gain substantially if more have access to effective care.
These consequences can have a high economic toll; however, most attempts to measure the costs of these conditions focus only on medical costs to the government. Yet, direct costs of treatment are only a fraction of the total costs related to mental health and cognitive conditions. Far higher are the long-term individual and societal costs stemming from lost productivity, reduced quality of life, homelessness, domestic violence, the strain on families, and suicide. Delivering effective care and restoring veterans to full mental health have the potential to reduce these longer-term costs significantly.
Therefore, it is important to consider the direct costs of care in the context of the long-term societal costs of providing inadequate care or no care. The RAND study sought to measure the total costs to society by factoring in treatment costs, losses or gains in productivity, and the costs associated with suicide. In addition, the study calculated the cost effect of getting more people into treatment and improving the quality of care.
Estimates of the cost of PTSD and major depression for two years after deployment range from $5,900 to $25,760 per case. Applying these per-case estimates to the proportion of the entire population of 1.64 million deployed service members (as of 2008) who are currently suffering from PTSD or depression, we estimate that the total societal costs of these conditions range from $4.0 to $6.2 billion, depending on whether the costs of lives lost to suicide are included. Of these 1.64 million service members, roughly 1/3 suffer from either TBI (traumatic brain injury), PTSD, or a combination of both - roughly 300,000 veterans returning from Iraq and Afghanistan suffer from PTSD or major depression and 320,000 may have experienced TBI during deployment.
The cost of TBI is substantially higher per case, but it varies according to the severity of injury. Estimates of the one-year cost of mild TBI range from $27,260 to $32,760 per case; estimates of moderate to severe TBI costs range between $268,900 and $408,520 per case.
Meeting the health care needs of returning troops who suffer from PTSD, depression, and TBI will be challenging. The prevalence of these conditions is high and may grow as the conflicts in Afghanistan and Iraq continue. The systems of care for meeting these needs have been improved, but critical gaps remain. Without effective treatment, these conditions carry significant long-term costs and negative consequences.
Why Don't Veterans Seek Help?
Lengthy wait times and/or lack of medical and mental health services through the Veterans Affairs Healthcare System
Personal embarrassment and/or shame about service related disabilities
Fear of being seen as weak or fear of retaliation among soldier units
Stigma associated with mental health/medical issues
A lack of understanding or lack of awareness about mental health/medical issues and treatment options
Logistical problems, such as long travel distances to access a VA in order to receive care
Concerns over the veteran mental health treatment/medical services offered by the VA
22+ Veterans commit suicide each day
50% of those with Post Traumatic Stress Disorder do not seek treatment
About 300,000 currently suffer from PTSD or major depression that have been "Diagnosed"
1 in 5 Veterans from Iraq and Afghanistan have been diagnosed with PTSD. That is nearly 300,000 veterans. However many Veterans go UN-diagnosed due to limited care in our facilities along with long wait times and huge travel expenses that are required if veterans do not live near a facility where they are "ALLOWED" to get diagnosed and treated. Out of the half that seek treatment, only half of them get "minimally adequate" treatment (RAND, 2008)