Only about half of veterans diagnosed with post-traumatic stress disorder after serving in Iraq and Afghanistan received the recommended treatment in 2013, according to a new report by the Institute of Medicine.
The report said only 53 percent of veterans with a primary diagnosis of PTSD received the eight psychotherapy sessions within a 14-week period, which is far short of the Department of Veterans Affairs’ target of 67 percent.
The study was commissioned by the VA and the Department of Defense (DOD), which collectively spent about $3.3 billion in 2012 treating PTSD. In its study, the Institute of Medicine looked at the success rates of the two departments’ PTSD programs and services.
The report found issues with PTSD treatment programs at the DOD, describing them as “adhoc, incremental, and crisis-driven with little planning devoted to the development of a long-range, population-based approach for this disorder.’’
The Institute of Medicine found the VA had a more unified structure than the DOD and offered a variety of treatment services for PTSD, but had little data to indicate whether performance measures in its mental health plans are being met.
The report recommended that the DOD and VA work together to “develop an integrated, coordinated, and comprehensive PTSD management strategy that plans for the growing burden of PTSD for service members, veterans, and their families.’’
The VA has been marred in scandal recently, coming under fire for long patient wait times for care and phony records hiding delays at VA hospitals and clinics nationwide.
The study, however, has been taking place for years, according to the Associated Press.
The first phase of study, released in 2012, recommended that soldiers returning from Iraq and Afghanistan undergo annual screening for PTSD and that federal agencies conduct more research into which treatments were working.
The wars in Iraq and Afghanistan have been associated with a notable increase of PTSD prevalence in the military, the new study noted.
Between 2004 and 2012, the percentage of all active-duty service members with a diagnosis of PTSD increased from 1 to 5 percent. In 2012, 13.5 percent of U.S. Army service members had PTSD, as did 10 percent of Marines, 4.5 percent of Navy personnel, and 4 percent of Air Force personnel. The same year, more than half a million veterans of all eras sought care for PTSD through VA health care services—making up 9.2 percent of all VA users. Almost 24 percent of these veterans (119,500) had served in the Afghanistan and Iraq conflicts.
The study found a lack of consistency in the implementation of PTSD treatment programs within the VA and DOD. In the DOD, leaders at all levels are not consistently held accountable for implementing policies and programs to manage PTSD effectively, according to the report.
With the VA, the report said leadership on PTSD management varied across VA sites resulting in different types and quality of PTSD programs and services.
The report recommended that DOD and VA leaders communicate a clear mandate, within each department, that PTSD has a high priority.
Another major issue highlighted in the report is a lack of data to measure the outcome of PTSD treatments, and to identify best practices for PTSD programs and services.
“Without tracking outcomes, neither department knows whether it is providing effective, appropriate, or adequate care for PTSD,’’ the report said.
While the report noted that both the VA and DOD are taking some steps to improve their data, it recommended that the departments develop and implement a measurement-based PTSD management system that documents patients’ progress during and after treatment.
Other recommendations from the report included creating a central database for programs and services, increasing engagement with the families of veterans with PTSD, and expanding PTSD-related research efforts.