PTSD Screening Recommended For Returning Troops
WASHINGTON — The Institute of Medicine recommended Friday that soldiers returning from Iraq and Afghanistan undergo annual screening for post-traumatic stress disorder and that federal agencies conduct more research to determine how well the various treatments for PTSD are working. Of the 2.6 million service members deployed to Iraq and Afghanistan, it’s estimated that 13 percent to 20 percent have symptoms of PTSD.
Barely more than half of those diagnosed with PTSD actually get treatment, often because many soldiers worry it could jeopardize their careers. Also, when soldiers do get care, they’re not tracked to determine which treatments are successful in the long-term.
The Defense Department provides medical care to active members of the military and the Department of Veterans Affairs cares for those who no longer serve. Sandro Galea, the chairman of the Institute of Medicine panel, said both departments offer many programs for PTSD.
“But treatment isn’t reaching everyone who needs it, and the departments aren’t tracking which treatments are being used or evaluating how well they work in the long term,” said Galea, a professor and chair of the epidemiology department at Columbia University. “In addition, DOD has no information on the effectiveness of its programs to prevent PTSD.”
In a recent speech to mental health provides, (recent) Defense Secretary Leon Panetta said commanding officers must make it understood that seeking help for the stresses of war should be seen as a sign of strength rather than as a sign of weakness.
PTSD is triggered by a specific traumatic event, such as being in combat or witnessing death. The symptoms of the illness include a numbing of emotions, difficulty concentrating and exaggerated startled responses to events.
The institute recommended therapies supported by robust evidence, such as working with patients to change their thinking and emotional responses to stress. But the committee’s analysis of other innovative treatments, including yoga, acupuncture and animal-assisted therapy, is hampered by a lack of evidence on their effectiveness.
Galea said that the two departments have been under quite a bit of pressure to get programs up and running to deal with the growing number of vets with PTSD.
The panel praised the two departments for issuing joint guidelines for managing PTSD, but it’s unknown whether their providers adhere to the guidelines. The panel said that primary care doctors within the VA screen Iraq and Afghanistan veterans annually for symptoms of PTSD, and it recommends that the Defense Department do the same.
The panel also called for more research to shed light on the brain’s defense mechanisms for stress, identify factors that can influence the timing and severity of symptoms and identify signs that could help lead to earlier diagnosis and more precise drug treatments.
The report said that the VA treated more than 438,000 veterans for PTSD in 2010, showing evidence of the widespread scope of the problem. Similar numbers are not available for the Defense Department.
Cynthia O. Smith, a DOD spokeswoman, said the department has already taken steps to address some of the issues raised in the report. “The department recognizes the need for continued improvements,” Smith said.
The VA said it would review the report and noted that it recently announced it was adding 1,600 clinicians and 300 support workers to its mental health staff. “We have already made strong progress, but we need to do more,” the department said in a written response to the report.