Combat Stress May Cost U.S. Up to $6 Billion

By Ann Scott Tyson
Washington Post Staff Writer
Friday, April 18, 2008

About 300,000 U.S. military personnel who have deployed to Iraq or Afghanistan are suffering from post-traumatic stress disorder (PTSD) or major depression, a mental toll that will cost the nation as much as $6.2 billion over two years, according to a Rand Corp. report released yesterday.

In addition, nearly 20 percent of the 1.64 million veterans of Iraq and Afghanistan, or about 320,000 personnel, reported a probable traumatic brain injury (TBI) during deployment, the report notes, although it says their treatment needs have not been determined.

The economic cost of the PTSD and depression cases -- including medical care, forgone productivity and lost lives through suicide -- is estimated at $4 billion to $6 billion over two years. Meanwhile, the cost incurred by traumatic brain injury, based on all cases diagnosed through June 2007, is estimated at $600 million to $900 million.

The 500-page report, titled "Invisible Wounds of War," says prolonged and repeated exposure to combat stress is causing a disproportionately high psychological toll compared with physical injuries. It warns of "long-term, cascading consequences" for the nation -- ranging from a greater likelihood of drug use and suicide to increased marital problems and unemployment -- if the mental health problems are left untreated.

Yet, based on a survey of 1,965 service members from 24 communities across the country, the study found serious gaps in mental health care. For example, it determined that only 53 percent of service members with PTSD or depression had sought help from a provider in the past year. Of those who sought care, about half received "minimally adequate" treatment.

Thousands more certified mental health professionals are needed to provide high-quality care in both military and civilian sectors, while more training for treating trauma is required for tens of thousands of existing providers, the report says.

Providing such care will require an effort that goes beyond the departments of Defense and Veterans Affairs to other parts of the U.S. health-care system, where veterans are also seeking care in part due to concerns of being stigmatized if they seek care from military facilities, it concludes.

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