Survey of West Virginia Veterans Shows Up to Half With Mental Health Conditions

The Times West Virginian

January 20, 2008 – Fairmont, West Virginia – A recent survey of West Virginia’s combat veterans of Iraq, Afghanistan and Kosovo suggests that nearly half may have symptoms of post-traumatic stress disorder (PTSD) and/or depression.

It’s not only the nearly 3,000 of the state’s 6,400 veterans of those conflicts who are affected by PTSD or depression, said Dr. Joseph R. Scotti.

Their spouses or partners and children are also affected, said Scotti, a clinical psychologist who teaches at West Virginia University.

“This represents over 5,000 family members who may be impacted and who may themselves be in need of services,” said Scotti.

“There are effective treatments for PTSD and depression,” but they require a lot of work by the individuals affected, Scotti said.

The first of its kind in the state, the survey will provide a baseline. He hopes it leads to more research and that more ways to provide outreach, counseling and assistance for the state’s veterans are developed soon.

A psychology professor for 18 years, Scotti has worked with a number of trauma survivors, including persons who have been in bad car wrecks and industrial accidents. He also has worked with veterans of World War II, Korea and Vietnam who have PTSD and depression.

The 108-item survey that he and others at the university developed for a special legislative committee gives a snapshot of the state’s recent combat veterans.
Ginny Majewski, chairperson of the Division of Social Work, was the co-leader on the Veterans Project.

Using a mailing list from the state Division of Veterans Affairs, the survey was mailed to 6,400 veterans in early December. The list was drawn from veterans who had earlier applied for a state bonus for service in Iraq, Afghanistan and Kosovo. About 1,000 surveys were undeliverable because of changes in address. The surveys included “scales” or questionnaires on PTSD and depression.

Of the 550 anonymous surveys which were returned, a total of 471 were entered and analyzed in time for a Jan. 6 meeting of the select committee, Scotti said.

The results reflect findings from other national and regional surveys on veterans with PTSD and depression.

The sample of 471 includes veterans from all 55 counties. The average age is 39, with a range in age from 20 to 76. Nine percent are women; 91 percent are men.

A total of 95 percent are white; two percent are black; and 1 percent each are Hispanic, Asian or American Indian.

A total of 71 percent have at least a high school degree; 20 percent have a bachelor’s degree; and nine percent have a post-graduate degree.

The sample yielded 170 veterans or 36 percent of the surveys which had scores suggestive of PTSD.

Post-traumatic stress disorder is an anxiety disorder.

According to an on-line page by the National Institute of Mental Health, “it can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened.”

“Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents or military combat,” the NIMH reference states.

In his report to the select committee, Scotti said PTSD is characterized by “re-experiencing the event or events via flashbacks, nightmares, intrusive thoughts, etc.”

Persons with PTSD also avoid “reminders of the event or events, people and places” and have “emotional numbing.”

They also show “hyperarousal” and are “on-guard, easily startled, and are often irritable due to disturbed sleep patterns.”

Depression, Scotti said, is characterized by: Feelings of sadness; worthlessness; fear and hopelessness; poor appetite; crying spells and other symptoms.

A total of 207 surveys or 44 percent had scores suggesting clinical depression, he said.

When the surveys were analyzed for PTSD and/or depression, the total came to 48 percent (226).

Noting 73 percent are married, 79 percent are living with a spouse or partner and 48 percent are living with an average of one child under the age of 21, Scotti said “it’s important that family members and children of the affected veterans get help as well.”

About 90 percent of the veterans know that services are available to them.

“However, only about half of the veterans having used a level of service found it helpful,” Scotti said.

The fact that the average veteran in the sample is 39 is a good sign, Scotti said. Returning Vietnam veterans were in their late teens or early 20s, he noted.

“Older is better. Older veterans have had more difficult life experiences that they have managed to deal with,” he said.

“They have learned more coping skills, and typically have more material and social resources they can rely on,” Scotti said.

That the majority of the latest crop of combat veterans also have marriages, partners and families also is a good sign.

But PTSD and depression symptoms wax and wane. Symptoms might not be evident for years after combat exposure for some veterans, he said.

If a veteran ignores the symptoms and doesn’t get treatment, however, “in a worst-case scenario, he or she could lose those supportive relationships.”

His recommendations include more awareness about the risks combat veterans have for PTSD and depression.

The outreach should include veterans and their families, particularly those in rural areas. It also should cover primary care and mental health providers.

Older veterans are a resource. Scotti would like to see programs developed for groups like the Veterans of Foreign Wars, American Legion and Vietnam Veterans of America.

Education is also needed for clergy, psychologists, counselors, social workers and medical professionals, he said.

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