Veterans and Mental Illness: A 2013 Update

Fifty-four percent of Iraq and Afghanistan war veterans who have sought treatment in the VA system since 2001 have been treated for mental disorders.

This is the second most-frequent diagnosis among these veterans.  It is an indicator of the profound effect recent war service is having on the mental health and well-being of our veterans.

The data come from a March, 2013, report entitled Analysis of VA Healthcare Utilization Among Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF) and Operation New Dawn (OND) Veterans.  

Here are some numbers that reflect how extensive the use of VA services has been during the last decade.

As of the end of 2012, 2.5 million troops had served since the beginning of the Iraq and Afghanistan wars.  Just over 1.6 million had become eligible for VA healthcare.  Of that group, almost 900,000 had used VA healthcare services by the end of 2012.

These 900,000 veterans most often sought treatment in VA centers in the south or in the west.  More than 85,000 sought treatment in the VA South Central Healthcare Network, while more than 80,000 sought treatment in the VA Desert Pacific Healthcare Network.  By contrast, less than 39,000 sought treatment in the VA New England Healthcare System.

Of those seeking treatment, 88 percent were male, and 12 percent were female.  93 percent had been seen on an outpatient basis only, while 7 percent had been hospitalized in a VA hospital on at least one occasion. 

Almost half were under the age of 30.

And the 550,000 who accessed care during 2012 alone represented 9 percent of the total number of veterans receiving VA care during the 2012 fiscal year.

And while – as might be expected – musculoskeletal system conditions were the most frequent diagnosis (58 percent) over the entire decade, nearly as many veterans (54 percent, or over 486,000) were diagnosed with mental disorders.

Many had two or more disorders.

Post-traumatic Stress Disorder, or PTSD, was the most frequent mental disorder treated in VA settings.  Over a quarter million OEF/OIF/OND veterans were treated for PTSD by the end of 2012.  But depressive disorders were nearly as prevalent, with more than 200,000 veterans being diagnosed with those.  Also, nearly 200,000 veterans were treated for neurotic disorders.

Together, these numbers provide strong statistical evidence that repeated exposure to environmental risk factors, including violence, are factors in multiple mental health conditions.

On the other hand, only 59,000 were diagnosed with alcohol dependence and only 32,000 with drug dependence.  These numbers suggest just as strongly that the mental disorders among returning veterans were not caused by risk factors within the control of the veterans themselves.

On Memorial Day, all of these data should give us pause to think about the inadequate federal and services and systems to which our OEF/OIF/OND veterans are returning. 

While the VA has taken steps in recent years to extend additional services to returning veterans, including allowing veterans to enroll in VA health services for up to five years after service and waiving co-pays for health problems related to military service, a significant number of veterans have not yet entered – or will never enter – the VA system.  

In addition, as a number of news outlets, including the Daily Beast, reported in March 2013, 245,000 veterans had been waiting for more than a year for disability benefits as of December 2012.  The average wait time for Iraq and Afghanistan veterans was between 316 and 327 days.

The federal government could be doing more for these men and women, but so could our states.

Funding for mental health services were cut by $4.6 billion by states between 2009 and 2012, and the unwillingness of many states to expand Medicaid benefits this year is certain to take a toll on many of our returning veterans and their families.   

We all know that this is no way to treat our returning veterans.

So as we raise our flags on another Memorial Day, we should never forget that our responsibility to those who serve our country extends over 365 days. 

Now is the time to pay back those for the sacrifices they have made.  Or are we so cold as to expect these mostly young veterans to have made this sacrifice – along with the toll it took on their health and mental health – all by themselves?   

To reach Paul Gionfriddo via email: gionfriddopaul@gmail.com.  Twitter: @pgionfriddo.  Facebook: www.facebook.com/paul.gionfriddo.  LinkedIn:  www.linkedin.com/in/paulgionfriddo/