Mental distress grows after return from Iraq

The mental health issue is worse for National Guard and Reserve soldiers.

WASHINGTON POST

WASHINGTON — Soldiers who have served in Iraq are suffering substantially greater mental distress several months after leaving the combat zone than they do when they first return to the United States, according to a study by Army researchers to be published tomorrow.

One out of five active duty soldiers and more than 40 percent of Army reservists needed treatment, according to the study.

Soldiers were far more likely to report mental health problems — which ranged from post traumatic stress disorder (PTSD) to depression — in a military screening three to six months after they returned from Iraq than they did immediately after they came home, according to the study, which will appear in the Nov. 14 issue of the Journal of the American Medical Association.

Particularly pronounced, it found, was the four- to five-fold increase in the number of soldiers reporting conflicts with family members and friends, which mirrors trends from past wars.

Initial screenings “substantially underestimate the mental health burden,” according to the study, which adds to growing evidence that more than a quarter of recent Iraq combat veterans are grappling with psychological problems.

The study, by Col. Charles S. Milliken and Col. Charles W. Hoge of Walter Reed Army Institute of Research and Jennifer L. Auchterlonie of the Army Center for Health Promotion, concludes that the Army needs to intervene earlier with more mental health care for combat veterans and their family members, “before symptoms become chronically entrenched.”

But it also cast doubt on the effectiveness of treatment for PTSD in what it called today’s “overburdened” military medical system, finding “no direct relationship of referral or treatment with symptom improvement.”

The study is based on Army health surveys completed by 88,235 soldiers who served in Iraq, 90 percent of whom were male and nearly 60 percent of whom were married. About 56,000 of those surveyed were in the active-duty Army, and 32,000 were in the Army Reserve or National Guard.

One reason the early screening detects fewer problems is that soldiers are elated upon returning home and do not want to spend time seeking care, Army officials said.

“When you come back ... you’re almost euphoric ... you don’t have any problems in the world,” said Brig. Gen. Stephen L. Jones, an Army assistant surgeon general. But after a few weeks, he said, “the stress starts to resurface.”

Though reports of mental health problems increased for all types of soldiers between the first and second screenings, the National Guard and Reserve soldiers suffered such problems at significantly higher rates than active-duty soldiers.

For example, in the second screening, 24.5 percent of reservists reported concerns with PTSD, 13 percent with depression, and 35 percent with their overall mental health, compared with 16 percent, 10 percent, and 27 percent of active-duty soldiers in the same categories.