Mental disorders plague more Iraq and Afghanistan veterans

WASHINGTON -- More than one-third of Iraq and Afghanistan veterans seeking medical treatment from the Veterans Health Administration report symptoms of stress or other mental disorders -- a tenfold increase in the last 18 months, according to an agency study.

The dramatic jump in cases -- coming as more troops face multiple tours in Iraq and Afghanistan -- has triggered concern among some veterans groups that the agency may not be able to meet the demand. They say veterans have had to deal with long waits for doctor appointments, staffing shortages and lack of equipment at medical centers run by the Veterans Affairs Department.

Contributing to the higher levels of stress are the long and often repeated tours in Iraq and Afghanistan. In Iraq, troops also face unpredictable daily attacks and roadside bombings as they battle the stubborn insurgency.

Veterans and Defense Department officials said the increase in soldiers complaining of stress or mental disorder symptoms also may suggest that efforts to reduce the stigma of such problems are working and that commanders and medical personnel are more adept at recognizing symptoms.

"It's definitely better than it was in past generations," said Paul Rieckhoff, executive director of the Iraq and Afghanistan Veterans of America.

Veterans Affairs officials say they have increased funding for mental health services, have hired at least 100 more counselors and are not overwhelmed by the rising demands.

"We're not aware that people are having trouble getting services from us in any consistent way or pattern around the country," said Dr. Michael Kussman, acting undersecretary for health and top doctor at the VA.

Nearly 64,000 of the more than 184,000 Iraq and Afghanistan war veterans who have sought VA health care were diagnosed with potential symptoms of post-traumatic stress, drug abuse or other mental disorders as of the end of June, according to the latest report by the Veterans Health Administration.

Of those, close to 30,000 had possible post-traumatic stress disorder, said the report.

The Government Accountability Office reported in February 2005 that just 6,400 Iraq and Afghanistan veterans had been treated for stress disorders. The office is an investigative agency of Congress.

Kussman said the numbers of people reporting symptoms of stress probably represent a "gross overestimation" of those actually suffering from a mental health disorder. Most of the troops who return from Iraq have "normal reactions to abnormal situations," such as flashbacks or trouble sleeping, Kussman said.

He said the returning Iraq and Afghanistan veterans represent just 3.5 percent of the more than 5 million people seen by the VA each year.

The VA, he said, has targeted $300 million for post-traumatic stress disorders for 2005-06, and is seeking another $300 million for 2007.

VA facilities largely serve veterans who have ended their military service, but some National Guard and Reserve members returning from the war are using VA facilities because they are closer to their homes.

While veterans groups don't have data on the number of veterans encountering problems with the VA, they said veterans are reporting long delays for appointments at the agency's medical centers.

"If they're going to keep recruiting anywhere near where they need to be, they'd better take care of the young vets, because everyone is watching," Rieckhoff said.

One soldier in Virginia Beach, Va., said he was having a hard time sleeping after he returned from Iraq, and was told he'd have to wait two-and-a-half months for an appointment at the VA facility, said Rieckhoff.

Rieckhoff said the Buffalo, N.Y., veterans medical center gave his organization a "wish list" of needed supplies and other expenses, including wheelchairs, rehabilitation equipment and medical monitors.

"If the VA is going to see 30 percent of the 1.5 million U.S. service members who have deployed to the wars in Iraq and Afghanistan, the VA may expect a total of 450,000 veteran patients from these two wars," said Paul Sullivan, director of programs for the Vietnam Veterans of America Foundation. "This is a very ominous trend, indicating a tidal wave of new patients coming in, and the numbers could go up."

The Defense Department has made mental health assessments and education programs mandatory for active-duty service members returning from the war. There are several dozen combat stress teams working with military units to prevent and identify stress or other mental health issues.

The department has also put a self-assessment screening on the Internet so military members can evaluate their symptoms.

Dr. Joyce Adkins, the Pentagon's director of stress management programs, said there has been a slight increase in the number of service members reporting mental health problems or symptoms.

"We've done a lot of education for service members at multiple times, to help them understand ... the common problems associated with deployment, the symptoms they might experience and what that might mean," she said.

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On the Net:

Defense Department: http://www.defenselink.mil

Military Mental Health Self Assessment Program: https://www.militarymentalhealth.org/