Behavioral Health Crisis

Hundreds of thousands of United States veterans are not able to leave the horrors of war on the battlefield (“Forever at War: Veterans Everyday Battles with PTSD” 1). Post-traumatic stress disorder (PTSD) is the reason why these courageous military service members cannot live a normal life when they are discharged. One out of every five military service members on combat tours—about 300,000 so far—return home with symptoms of PTSD or major depression. According to the Rand Study, almost half of these cases go untreated because of the disgrace that the military and civil society attach to mental disorders (McGirk 1). The general population of the world has to admit that they have had a nightmare before. Imagine not being able to sleep one

Over the last decade, the wars in Afghanistan and Iraq have drastically increased the need for effective mental health services and treatment for U.S. veterans and service members, especially those suffering from Posttraumatic Stress Disorder (PTSD). Nearly 1.5 million American service members have been deployed in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) since the attack on the Twin Towers in September 2001 (Price, Gros, Strachan, Ruggiero, & Acierno, 2013). Approximately 25% of soldiers and wounded warriors returning home from OEF/OIF present with mental illness due to combat-related violence and other trauma exposure (Steinberg & Eisner, 2015). According to Price and colleagues (2013), OEF/OIF soldiers and veterans are at greater risk for developing mental illness compared to others who served in past military operations.

Today, hundreds of thousands of service men and women and recent military veterans have seen combat. Many have been shot at, seen their buddies killed, or witnessed death up close. These are types of events that can lead to Post- Traumatic Stress Disorder ("Post Traumatic Stress Disorder PTSD: A Growing Epidemic. “) Anyone that has gone through a traumatic event can be diagnosed with PTSD but research shows, military men and women are more susceptible to having PTSD (PTSD: A Growing Epidemic.) And, with little help from the US, many Veterans do not get the help they need or get treated for PTSD. Military men and women begin to

Perhaps attesting to the enhanced understanding of PTSD and alarm at the troubling suicide rates of veterans, the media seems to be raising the public’s attention about the condition, for example, through the use of documentaries. In 2005, during the second push of the Iraqi and Afghanistan war PBS FRONTLINE released a documentary entitled, “The Soldier’s Heart,” This documentary gives an overview of the history of PTSD, but focuses specifically on the psychological toll of the Iraq war. It illuminates the fact that despite advances in our understanding of PTSD, there continues to be a stigma against psychological problems in the

The VA runs the largest substance use disorder treatment program in the world. Treatment of veterans with SUDs and co-occurring psychiatric disorders is one of the following three paradigms; parallel, sequential, and integrated. Most VA programs are parallel, where the patient receives treatment for SUD in one program and treatment for PTSD in another. Many SUD-PTSD veterans may be unable to navigate the separate systems or make sense of the disparate messages about PTSD treatment and recovery. One challenge to dissemination and implementation of EBTs is that of dual disorders, particularly SUD and PTSD. These patients use costly inpatient services, tend to have frequent relapses, and are less likely to adhere to or complete treatment.

Bennett, PhD; Hilary J. Liberty, Ph 2013 107). Prior research has evaluated the prevalence of MH concerns and opportunities for treatment at various points in the military/veteran career including post deployment, among those being treated at Veterans Affairs (VA) facilities, and in the general population) (Andrew Golub, PhD; Peter Vazan, PhD; Alexander S. Bennett, PhD; Hilary J. Liberty, Ph 2013 107). The National Survey on Drug Use and Health (NSDUH) data indicate that a substantial portion of young veterans in the general population have substance use disorder (18%) or Serious Psychological Distress (SPD) (14%) (Andrew Golub, PhD; Peter Vazan, PhD; Alexander S. Bennett, PhD; Hilary J. Liberty, Ph 2013 111). All in all, the NSDUH proved to be an extremely valuable resource for this study, and indeed, the results of this analysis for unmet treatment needs have identified important directions for further research into reasons for not getting treatment, especially for SPD (Andrew Golub, PhD; Peter Vazan, PhD; Alexander S. Bennett, PhD; Hilary J. Liberty, Ph 2013 113). The Veterans Administration and National Survey on Drug Use and Health (NSDUH) are taking steps in the right direction to help our veterans with their unmet needs with substance abuse and PTSD. Some examples of improvements are, better mental health evaluations before leaving active duty, more information about military service, and tracking trends among veterans in the general population, who are not necessarily in contact with the

There has been an increase in veterans, approximately 107,000 whom are unemployed and homeless, while 1.5 million veterans are poverty and homeless. These veterans live in various dismal conditions suffering from disorders while lacking social support. (National Coalition for Homeless Veterans) This epidemic attracts the attention of politicians, sociologists, etc. whom are unconcerned with the fate of veterans in America. Professor Tull, insisted that to resolve the problem, he argued that the main reason for homelessness was that the veterans had PTSD which had negative influences. (Tull) This reason is that the PTSD should be treated with various ways, such as cognitive-behavioral treatment, which unfortunately some veterans can’t handle

The video I chose to watch was “The Wounded Platoon”. The population related to this video that faces difficulties in terms of access to health care are United States veterans. This video specifically mentions veterans of the Third Platoon, who were deployed to fight during the Iraq War. One overarching difficulty this population has in terms of access to health care is a lack of wanting to come forward. One soldier stated that those who came forward with symptoms of Post-Traumatic Stress Disorder (PTSD) feared ridicule. PTSD is very stigmatized, especially in the military, where it is stated that coming forward with symptoms of PTSD could be considered “a sign of weakness”. Many veterans claimed they did not need help and reported no mental duress. However, it was shown that many of these veterans were self-medicating. It was stated that there was an over three thousand percent increase in Fort Carson soldiers failing drug tests after the Iraq War.

Rates of trauma and mental illness are reported to be disproportionately higher among American veterans, especially those of the recent wars in Iraq and Afghanistan. The barriers to care after civilian reentry further disadvantage this already vulnerable population. The wars in Iraq and Afghanistan have been the longest sustained US military operations since the Vietnam era, sending more than 2.2 million troops into battle and resulting in more than 6,600 deaths and 48,000 injuries. Veterans are at risk mental health challenges, as well as family instability, elevated rates of homelessness, and joblessness. Veterans have disproportionate rates of mental illness, particularly posttraumatic stress disorder (PTSD), substance abuse disorders, depression, anxiety, and military sexual trauma.

Both articles identify the issue of providing mental health services for veterans with an extra emphasis on those that served in Afghanistan and Iraq (OEF/OIF veterans). It is no surprise that returning veterans suffer from both visible/invisible (physical and mental) wounds. Most veterans have this “high” expectation that they are going to receive quality care from both the DoD and VA. Unfortunately reality steps in where veterans are slapped in the face because they are receiving a lack of poor quality care all while jumping through Beuracractic hoops. The challenges faced to access these services include resistance, stigma, lack of professionalism, and geographic and/or regional disparities in the distribution of services resources and/or benefits, and the system simply refusing to change.

99). Similarly, both articles mentioned PTSD symptoms as being a barrier overlapping with depression. Baker, Kilmer, Lemmer, Goldsmith, and Pittman (2012) provided more in-depth information that focused primarily on PTSD and depression as to where Connor et.al (2013) looked into more barriers other than the overlapping symptoms as being reasons for barriers for treatment in combat veterans.  Baker et. al (2012) examined 2 significant mental  health issues including PTSD and depression in OEF/OIF combat veterans in their entire research study.  These researchers found that health related quality of life (HRQoL) is highly affected in both disorders. Although the study used a clinician-administered PTSD scale (CAPS) as well as standardized and structured interviews conducting to the DSM-5 criteria, the fact alone remains that the overlapping symptoms could be difficult for veterans to understand. The participants in this study consisted of 200 OEF/OIF veterans who completed an interview as well as self-report questionnaires. The sample included 95% men, 45% active duty, 55% veteran; ages 19-52, median 27%; 77% non-Hispanic/Latino, and 80% white. The findings revealed that PTSD and depression have overlapping symptoms as anhedonia, concentration, and insomnia. In conclusion, the results from the

Many veterans are unable to leave behind the trauma of Vietnam and psychologically return home. They struggle with a variety of extremely severe problems that neither they nor their families, friends, or communities knew how to understand

Military Pathway (2013) concluded “Military life, especially the stress of deployments or mobilizations, can present challenges to service members and their families that are both unique and difficult”. Hence, it is not surprising that soldiers returning from a stressful war environment often suffer from a psychological condition called Post-Traumatic Stress Disorder. This paper provides a historical perspective of PTSD affecting soldiers, and how this illness has often been ignored. In addition, the this paper examines the cause and diagnosis of the illness, the changes of functional strengths and limitations, the overall effects this disease may have on soldiers and their families, with a conclusion of

T. Stecker, J. Fortney, F. Hamilton, and I. Ajzen, 2007, address that mental health symptoms have the likelihood to increase within post deployment for military veterans, especially for the ones who have seen combat. An estimated quarter of recent war veterans who are currently receiving care in the Department of Veteran Affairs (VA) Health Care System have reported mental health problems. Soldiers who have served in Iraq come home suffering from depression, anxiety, and posttraumatic stress disorder (PTSD). The Statistics of Iraq soldiers meeting the criteria for depression, anxiety, and posttraumatic stress disorder (PTSD) is greater than the soldiers who served in Afghanistan. The mental health symptom rates for soldiers who served in Iraq were as high as 20% for PTSD, 18% for anxiety, and 15% for depression.

Military members will seek mental health care from military providers for psychological disorders. “Since October 2001, approximately 1.64 million United States troops have been deployed to support Operations in Afghanistan and Iraq.”1 Returning home from a deployment comes with its own set of challenges but a psychological disorder is a wound that cannot be seen from the outside and needs just as much care and treatment as a physical injury. The military offers several options in an effort to assist or mitigate these conditions through a mental health provider. This paper will cover the pros and cons of receiving treatment from a behavior health medicine military doctor as well as justify why military members will get help from military providers.