In the first comprehensive review of the government’s programs for treating post-traumatic stress disorder in service members and veterans, a panel of experts recommended Friday that the Defense Department and the Department of Veterans Affairs expand access to services, particularly for people in rural areas, in the National Guard or the Reserves, or in combat zones.
The report, by the Institute of Medicine, also concluded that the two departments need to improve their assessment of how well their many treatment programs work, as well as find better ways of coordinating care that can begin overseas and then continue on bases or in small towns across the country.
“There is a tremendous amount of good-will effort in both departments to provide good treatment,” said Dr. Sandro Galea, a professor of epidemiology at Columbia University and the chairman of the committee. “The challenge is that in the rush to deliver treatment, assessment and monitoring has not been implemented rigorously, and that is a missed opportunity.”
The nearly 400-page report represents the first half of a multiyear review of the broad range of PTSD screening and care services provided by the two departments. A second report, to be released in 2014, will assess emerging treatments.
The Pentagon is financing the study by the institute, part of the National Academy of Sciences. The 14 panel members include leading academicians in psychiatry, social work, family medicine and public health.
PTSD, an anxiety disorder set off by traumatic experiences, is estimated to affect as many as 1 in 5 of the 2.6 million service members who have deployed to Iraq or Afghanistan since 2001. The disorder, with symptoms that include flashbacks, sleeping problems, irritability and hypervigilance, often does not emerge for months or even years after a deployment.
In the second phase of its review, the panel hopes to get comprehensive data and demographic information on the troops and veterans who have received a diagnosis of PTSD, as well as on the treatment they received and the cost of that care.
Those statistics would provide a significant step forward in understanding the breadth and depth of PTSD, since current efforts to estimate its prevalence vary widely.
“The data exists,” Galea said, “but it is scattered in many systems.”