The Army has ordered comprehensive reforms in how it diagnoses and treats post-traumatic stress and other mental health issues, according to a report being released Friday.

Sen. Patty Murray, (D-Wash.)

The actions stem from a service-wide review begun in May in response to concerns that some soldiers had their diagnoses reversed because of the costs of caring for them.

The report makes 47 recommendations as part of a comprehensive action plan that Secretary of the Army John M. McHugh ordered implemented Tuesday.

“The sheer number of changes this report recommends is indicative of the size and scope of the problem,” said Sen. Patty Murray, (D-Wash.), who pushed for the investigation after disclosures that some soldiers had PTSD diagnoses rejected during subsequent evaluations at Joint Base Lewis-McChord in Washington state.

The Army Medical Command reviewed the mental health diagnoses of 146,000 for soldiers between 2001 and 2012, according to the report.

The rate of diagnostic change for PTSD was similar to changes in other behavioral health diagnoses, “suggesting that PTSD is not handled differently than other diagnoses,” the report says. Over 6,400 soldiers had their diagnoses adjusted, but about the same number of soldiers had a PTSD diagnosis added as had other changes, according to the report

“Importantly, this report reviewed our systems holistically-recommending not only short-term solutions, but longer term, systemic changes that will make care and treatment of our soldiers and family members more effective,” McHugh said in a cover letter attached to the report.

“This isn’t an issue of not having the resources to make changes,” said Murray. “Instead, it is simply a matter of problems that have been allowed to persist while far too many soldiers fell through the cracks.”

A separate, Department of Defense-wide review is expected to be completed this fall, according to Murray’s office.