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Many Returning Soldiers May Require Mental and Behavioral Health Services

The nation's health care system for returning soldiers is facing a potential deluge of tens of thousands of men and women in uniform returning from Iraq with serious mental health problems brought on by the stress and carnage of war.

  • Some Pentagon experts predict that the number of returning soldiers eventually requiring mental health treatment could exceed 100,000 (Shane, 2004). PTSD is only one of several possible psychological outcomes following trauma. It is important to remember that substance abuse, depression, generalized anxiety disorder, and adjustment disorders have also been associated with traumatic exposure, fear of capture, injury, and death, as well as exposure to debilitated conditions of prisoners of war and dead bodies (Ursano & Norwood, 1996).

  • A recent GAO report (February 2005) found that officials at six of seven Veterans Affairs medical facilities surveyed said they "may not be able to meet" increased demand for treatment of PTSD. Officers who served in Iraq say the unrelenting tension of the counterinsurgency will produce that demand (Shane, 2004).

  • The GAO Report further states that if returning military personnel do not have access to PTSD services, the chance may be missed for early identification and treatment to lessen the severity of the symptoms and improve the quality of life of those returning from combat (Shane, 2004).

  • A survey published by the Army Surgeon General noted there is approximately one behavioral health provider for every 900 soldiers. This could explain why only 27 percent of soldiers who screened positive for depression, anxiety, or traumatic stress said they had received any services from a mental health provider during their deployment (Daw Holloway, 2004).

  • A longitudinal study of Gulf War Vets suggests that the prevalence of PTSD increases during the first two years after the soldier’s return (Wolfe, Erickson, Sharkansky, King, & King, 1999).

  • Returning soldiers are at a higher risk for attempted suicides and need to be monitored closely. In 2003, the suicide rate among Army troops in Iraq was 15.6 per 100,000 soldiers, an increase from 11.9 per 100,000 soldiers (Bennis, 2004).

  • The effects of sexual assault occurring within a military unit. These experiences can lead to a heightened sense of apprehension and vulnerability because the victim must continue to live and work closely with the perpetrators (Friedman, 2005; Murdoch et al., 2003). Victims are often silenced by peer pressure, unreceptive leaders, or the fear of jeopardizing their careers (Friedman, 2005). Sexual assault is extremely common in women veterans (Fisher McNulty, 2005; Murdoch & Nichol, 1995). They are at high risk for developing PTSD (Baker, Boat, Grinvalsky, & Geracioti, 1998; Valentiner, Foa, Riggs, & Gershuny, 1996) major depressive episodes (Hankin et al., 1999) and anxiety disorders (Burman et al., 1988). They are also more likely to attempt suicide (Davidson, Hughes, George, & Blazer, 1996) and abuse drugs and alcohol (Burman et al., 1988).

  • The unprecedented numbers of women serving in combat roles and situations. The women in the military today are younger, more ethnically divers, and have fewer socioeconomic resources (Stern et al., 2000; Sorensen & Field, 1994). Although there is several researchers have studied the health effects of the stressors of environments on military women (Bell & Roth, 1998; Norwood & Ursano, 1997; Murphy, Browne, Mather, Scheele, & Hymas, 1997), there is relatively little data regarding gender differences as it relates to how they experience environmental stressors and the implications that this may have on their physiological and psychological health.

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