A report from the Institute of Medicine (IOM) finds that the U.S. Department of Defense (DOD) and U.S. Department of Veterans Affairs (VA) do not measure the effectiveness of treatment of post-traumatic stress disorder (PTSD), calling into question millions of dollars spent to improve service members’ mental health. The IOM Committee and report, chaired by Columbia Mailman School’s Dr. Sandro Galea, chair of the department of epidemiology, also found that neither agency has kept pace with growing demand for PTSD treatment.
“Both departments lack a coordinated, consistent, and well-developed evidence-based system of treatment for PTSD and need to do a better job tracking outcomes,” said Dr. Galea, who is chair of the Department of Epidemiology at the Mailman School of Public Health. “Mental health is among the most important factors behind successful re-entry after military service, and we do not know if treatments are working.”
The IOM issued this report on the heels of a scandal at the Department of Veterans Affairs that led to the resignation of VA Secretary Eric Shinseki on May 30. Federal investigators determined that service members were systematically denied timely care in a network of more than 1,700 health care facilities that suffer from inefficiency and bureaucracy.
PTSD is diagnosed by a combination of symptoms, including hypervigilence and sleeplessness, and can be treated pharmacologically and psychologically with cognitive behavioral therapies involving multiple sessions with trained counselors.
An estimated 5 percent of service members have been diagnosed with PTSD; for veterans who served in Iraq and Afghanistan conflicts, the number rises to 8 percent. In 2012, more than half a million sought care for PTSD in the VA – 9.2 percent of all VA users. In 2012 the DOD and VA spent $294 million for PTSD care. If treatment demands continue to climb, the total cost for PTSD could exceed $500 million by 2017.