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[h=4]Study: Military falls short in treating new cases of war-related stress[/h]While military improves follow-up mental care for troops, therapy still falls short.
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PTSD; How it works
A massive new RAND Corp. study shows the U.S. military is struggling to provide follow-up therapy sessions for for troops with post-traumatic stress disorder or depression after being diagnosed, a period when many suicides occur.(Photo: Scott Olson, Getty Images)
The U.S. military is struggling to provide adequate therapy sessions for thousands of active-duty troops suffering from post-traumatic stress disorder and depression,<span style="color: Red;">*</span>a massive study released Thursday concludes.
The RAND Corp. study of 40,000 cases, the largest ever,<span style="color: Red;">*</span>found that only a third of troops with PTSD<span style="color: Red;">*</span>and less than a quarter who are clinically depressed<span style="color: Red;">*</span>receive the minimum number of therapy sessions after being diagnosed.
A RAND review of U.S. military and Department of Veterans Affairs treatment guidelines concluded that<span style="color: Red;">*</span>troops diagnosed with PTSD should receive at<span style="color: Red;">*</span>least four therapy sessions within eight weeks or at least two sessions to manage<span style="color: Red;">*</span>newly prescribed medications.
The good news in the study: vast improvement in how the Army and other service branches<span style="color: Red;">*</span>follow up with inpatient<span style="color: Red;">*</span>cases of PTSD after servicemembers<span style="color: Red;">*</span>are released from mental hospital care, a crucial period when many suicides occur.
“We just don’t have enough mental health professionals to meet the demand,”<span style="color: Red;">*</span>said Brad Carson, acting principal deputy undersecretary of defense for personnel and readiness.
He said the military will turn increasingly to civilian therapists available through Pentagon contracts. Carson also plans to examine the RAND findings "to see ways that we can improve."
Since 2009, the military has<span style="color: Red;">*</span>increased mental health professionals on staff by 42% to 9,295.
The study examined<span style="color: Red;">*</span>treatment for a year following<span style="color: Red;">*</span>diagnoses in<span style="color: Red;">*</span>2012.<span style="color: Red;">*</span>There were 8,286 diagnosed with PTSD, 24,251 with depression<span style="color: Red;">*</span>and 6,290<span style="color: Red;">*</span>suffering from both illnesses.
RAND described the study as<span style="color: Red;">*</span>the largest<span style="color: Red;">*</span>independent examination of mental health treatment in the military.
Army research found<span style="color: Red;">*</span>that one of the most vulnerable periods for suicide by<span style="color: Red;">*</span>soldiers is during the year after being released from hospital care. The suicide rate for soldiers in this group was 264 per 100,000,<span style="color: Red;">*</span>far outpacing the national suicide rate of 13 per 100,000 people.
The RAND study shows the military has become more aggressive in treating servicemembers after they are released from in-patient psychiatric care. About<span style="color: Red;">*</span>86% of those with PTSD or depression had a follow-up session with a<span style="color: Red;">*</span>mental health specialist within seven days after being discharged, and the rate jumped to more than 95% for seeing a therapist within 30 days, according to the study.
"This is a very important, high-risk time for these servicemembers," said Kimberly Hepner, a clinical psychologist and<span style="color: Red;">*</span>lead author of<span style="color: Red;">*</span>the RAND study. "This is a prime example of where they (the U.S. military medical system) really out-performed all other available data."
She said the<span style="color: Red;">*</span>military's<span style="color: Red;">*</span>rate of success in this category was higher than in civilian medical care and the Department of Veterans Affairs.
But the study also shows<span style="color: Red;">*</span>the military must provide more therapy<span style="color: Red;">*</span>quickly after a diagnosis of PTSD or depression, Hepner said.
“Are there enough visits at the beginning<span style="color: Red;">*</span>to give the servicemember a good start at getting effective treatment?<span style="color: Red;">*</span>And that’s really a key place where we saw that the military health system could improve,” she said.
The RAND study cited a 2014 internal Army medical command<span style="color: Red;">*</span>memorandum emphasizing the need to see soldiers within 72 hours of being discharged from a<span style="color: Red;">*</span>hospital. It urges commanders to require a soldier to attend a session if one is missed. It also says<span style="color: Red;">*</span>no one will be discharged during a weekend or holiday to avoid losing track of follow-up care.
About 2.6 million U.S. servicemembers served in Iraq or Afghanistan from 2001 through<span style="color: Red;">*</span>2014. Rates of PTSD among these troops ranged from 4% to 20%, with depression rates ranging from 5% to<span style="color: Red;">*</span>37%, depending on the study.
RAND<span style="color: Red;">*</span>researchers found that the Pentagon could improve<span style="color: Red;">*</span>how rapidly doctors review the progress of a servicemember who was<span style="color: Red;">*</span>placed on medication after being diagnosed with PTSD or depression. Only 45% of those with PTSD and 42% of those with depression had their medication progress<span style="color: Red;">*</span>reviewed within 30 days after diagnosis, which is a proper standard, according to the RAND study.
About 70% of those studied were in the Army, more than 90% of those who had PTSD had been deployed<span style="color: Red;">*</span>and the average deployment was 20 months. The average profile of a patient in the military with PTSD or depression was a soldier<span style="color: Red;">*</span>34 years old or younger, white and married.
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