A new report published by the Institute of Medicine states more than 40 percent of veterans returning from wars in Iraq and Afghanistan are not provided with adequate health services, particularly relating to mental health. While insurance exists, the services are not effective or prevalent enough to deal with the growing mental health epidemic.
The findings coincide with the growing number of suicides among veterans. A report released in February by the Department of Veterans Affairs indicates 22 veterans kill themselves every day, equating to one suicide every 65 minutes.
Active duty suicides are also skyrocketing, estimated at one-per-day — an 18 percent increase from 2011. The numbers exceeded those predicted by the Pentagon, adding 136 active-duty suicides.
While active-duty suicide numbers are exceeding past years, the percentage of returning veterans killing themselves is slightly lower than figures from 1999. Yet considering the increase in active duty troops, the total number of soldiers falling to suicide is increasing rapidly.
“In many cases, the response does not match the magnitude of the problems, and many readjustment needs are unmet or unknown,” the Institute of Medicine stated. “The urgency of addressing those issues is heightened by the sheer number of people affected, the rapid draw down of personnel from Afghanistan and Iraq, and the long-term effects that many of the issues might have not only on military personnel and veterans and their families but on the country as a whole.”
Since the wars in Iraq and Afghanistan began, nearly 2.2 million troops have served overseas, including men and women in what has been the longest U.S. military mission since the Vietnam era, according to the Institute of Medicine report.
As the report details, the wars in Iraq and Afghanistan were unique, as multiple tours of duty were common practice, including by those who serve in the National Guard, which typically do not deploy.
“These unique circumstances cause unique problems for service members, veterans and their families, both during and after deployment to Iraq and Afghanistan,” the report states.
A high rate of unemployment upon returning home from war is also addressed, as veterans between the ages of 18 to 24 experience a 30.2 percent unemployment rate, compared with the 16.1 percent rate experienced by civilians, according to the report.
Addressing death
The Department of Veterans Affairs (VA) has increased its efforts of addressing mental health disorders, including those related to Post Traumatic Stress Disorder (PTSD). A toll-free Veterans Crisis Line was created to handle the increased veteran needs, and suicide prevention coordinators have been stationed at veterans affairs medical centers.
Yet, according to the numbers, it’s not enough.
“The mental health and well-being of our courageous men and women who have served the Nation is the highest priority for VA, and even one suicide is one too many,” VA Secretary Eric Shinseki said in a press release. “We have more work to do and we will use this data to continue to strengthen our suicide prevention efforts and ensure all Veterans receive the care they have earned and deserve.”
The VA report, considered the most elaborate of its kind, was released months before the Institute of Medicine report, commissioned by Congress in order to address how to deal with the growing veteran mental health epidemic.
In 2009, Congress tasked the Institute with conducting a two-phase report, the second of which was released Tuesday. The Institute report confirms what Congress has known all along — there is a need for more services. As pointed out in the report, however, there’s also a need for improvement in the processes currently in place, including uniformity in addressing and documenting care.
“When care departments from the scientific evidence base and varies significantly from clinician to clinician, patients may receive poor quality care,” the report state.
Additional components of the report that look at issues not often highlighted, including unique mental health needs of women and minorities.
Today, women make up nearly 16 percent of those enlisted in the Army, compared to nearly 10 percent in 1983. Twenty-six percent of those currently serving in the army are considered minorities.
Report recommendations include support for females, minorities
As part of the first phase of its report, the Institute of Medicine made recommendations for the Department of Defense and Department of Veterans Affairs, specifically relating to addressing mental health issues.
Key to its recommendations two main issues associated with care now, which includes a lack in capacity to adequately treat a veteran population that is larger now than the nation has seen since the Vietnam era. It also addresses the stigma attached to seeking mental health services, which is all too prevalent in military culture.
Part of the plan is to locate where professionals are needed to address mental health issues of returning veterans and their families. It’s also recommended the government fund research to create guidelines relating to long-term treatment for those suffering from brain injury.
One suggestion specifically relates to veterans who have served multiple tours of duty, including how this may impact domestic violence. Care for effective mental health treatment for women and minorities is also addressed, citing the need to understand unique threats to that population.
According to the Department of Veterans Affairs, minorities who served in the Vietnam era suffered a higher rate of PTSD than White veterans.
New to this report is the notion that sexual assault within the military, inflicted upon women, which is a growing issue that all too often leads to psychological complications.
“DOD should intensify its efforts to eliminate sexual harassment and assault, a problem that affects a significant percentage of current and former female service members and can have lingering emotional and health consequences,” an Institute of Medicine press release states.
A study previously released by the Institute of Medicine indicated 21 percent of women reported military sexual trauma — and the real numbers could be higher considered more than 80 percent of cases are regarded as going unreported. The same report noted that women who suffer sexual assault are nine times more likely to develop PTSD.