Mental Health and Brain Injury Issues for Returning Vets: Astonishing Numbers

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The RAND Institute issued a comprehensive study of mental health issues and brain injury problems experienced by Iraq and Afghanistan veterans. According to the study nearly 20% of the returning veterans (300,000 soldiers) report symptoms of PTSD or major depression. Slightly more than half have received treatment. The study also revealed that 19% report a possible brain injury and 7% report a probable brain injury with PTSD or major depression. The study noted that many service members do not seek treatment due to concerns with the recognition of psychological problems being a blemish on their careers. For those who seek treatment, the RANDS researchers consider the treatment to be "minimally adequate". Terri Taniellan, the RAND project co-leader, called the problem "a major health crisis facing the men and women who have served in Iraq and Afghanistan". The RAND project targeted three areas: to identify psychological and cognitive injuries among those who have served; to develop economic modeling to study the costs associated with providing treatment, lost productivity and suicide; and to assess the availability of existing treatment and the barriers to access. Lisa Jaycox, a RAND study co-leader, referred to untreated PTSD and depression as "a cascading set of consequences". The RAND study estimated that the two year cost of PTSD and depression post-deployment ranged from $6,000 to $25,000 per case. The societal cost was between $4 billion to $6.2 billion.

The RAND study identified 320,000 service members who may have received a traumatic brain injury during deployment. This includes the range from concussive injuries through severe and catastrophic injuries. Only 43% were ever evaluated by a physician for their injury. The one year costs associated with a Mild Brain Injury were $32,000 per case. The moderate to severe injuries ranged from $268,000 to $408,000 per case over the one year period. The one year societal impact for  2700  brain injury cases identified to date range from $591 million to $910 million. These numbers will increase significantly as more individuals are evaluated and deemed to have a brain injury. Over the course of the next fifty years, the societal costs for brain injury involving service members will be enormous.

The newly created Defense Center for Excellence for Psychological Health and Traumatic Brain Injury has a herculean task over the next few years. It can truly become a center of excellence with adequate funding, trained personnel and an agenda directed towards identifying problems and providing treatment.The needs of the returning service members with psychological and brain injury related problems requires a call to action in the newly organized Center. 

The RAND report is entitled: Invisible Wounds of War:Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery" and may be found at rand.org.

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