March 6, 2009 – A new study from the Armed Forces Health Surveillance Center shows that service members spend more time in the hospital for mental health disorders than for any other condition.
Post-traumatic stress disorder and other mental health issues due to combat operations “degrade the health, fitness, operational effectiveness and morale of affected service members and their units,” according to a report by Stephen Taubman of the Surveillance Center’s Data Analysis Group.
Taubman looked at active duty service members who deployed to Iraq or Afghanistan from January 2002 to December 2008. During that period, about 1 million people deployed, and about 200,000 received medical treatment for a mental health disorder after deploying.
About 80,000 sought treatment for a mental health disorder before they deployed. Of those who sought treatment before they deployed, 40 percent also talked with a therapist at least once after they returned from deployment.
In fact, those who had been diagnosed with PTSD or depression before deploying were almost three times as likely to seek treatment again. Taubman found that of those with no prior history of mental health issues, only 3 percent were diagnosed with depression after deploying and 3.4 percent were diagnosed with PTSD. However, 7.4 percent were diagnosed with adjustment disorder — which consists of the same symptoms as PTSD, but short of the six-month baseline for PTSD — and 11 percent were diagnosed with “other” disorders.
“In general, deployers who are hospitalized for illnesses or injuries prior — particularly shortly prior — to the time of deployment are relatively likely to have significant illnesses or injuries during and after deploying, particularly from the same conditions,” Taubman wrote.
There were higher correlations between before-and-after diagnoses for those who came in for a mental health issue 30 days or fewer before deploying, the research shows.
Taubman also found differences among the services: 9 percent of soldiers had been diagnosed with mental disorders before deploying and 27 percent after, while 5 percent of Marines had been diagnosed before deploying and 15 percent after. Military mental health professionals attribute that, in part, to Marines’ shorter deployment lengths. For the Air Force, 8 percent have mental health issues before deploying and 19 percent after; for sailors, it’s 7 percent before and 16 percent after; and for the Coast Guard, it’s 7 percent before and 20 percent after.
There were also differences between men and women. Of women, 14 percent had mental health encounters before deploying and 28 percent after; 7 percent of men had mental health encounters before deploying and 21 percent did after. Healthcare workers had the highest rates, with 12 percent seeking help before deploying and 30 percent going in after deployment.
“This report documents very strong relationships between the natures and timing of mental disorder-related medical encounters before and after deploying to Iraq and Afghanistan,” Taubman wrote. “The natures of their mental disorders before deploying were very strong predictors of the types of mental disorders diagnoses they received after deploying.”
However, he said the research did not take into account how many people had deployed more than once, or how many seeking mental health help may have improved since 2002 as the military works to reduce stigma. It also can’t include people who sought care outside military providers.
“The findings of this analysis suggest that reviews of medical records should be incorporated into predeployment health assessments,” Taubman wrote. “Such reviews may provide useful information and insights regarding the current mental health status, fitness and readiness for deployment of individuals — as well as the most important threats to their short- and long-term mental health.”
