One in five US soldiers have depression or post-traumatic stress disorder, study finds

A study has found that 18.5% of current and former US service personnel report symptoms of depression or post-traumatic stress disorder. And 19% report symptoms that indicate traumatic brain injury, ranging from mild concussions to severe penetrating head wounds. An estimated 7% have both probable traumatic brain injury and depression or stress disorder.

The study, by the Rand Corporation, and sponsored by the California Community Foundation, an independent non-profit making think tank, is thought to be the first large private assessment of its kind. It included a survey of 1965 active and veteran military personnel; focus groups with service members and their families; and interviews with key administrators and healthcare providers throughout the United States.

The Department of Defense estimated that 1.6 million service personnel have been deployed in the wars in Afghanistan and in Iraq.

The study found that only about half of personnel with depression or post-traumatic stress disorder have sought treatment. Even fewer personnel with traumatic brain injury have been evaluated by a doctor.

Barriers that inhibited the personnel surveyed from getting treatment were concerns that treatment would not be kept confidential and would constrain career advancement. Almost half of the 1965 respondents worried that drugs for mental health problems might have unpleasant side effects, and about one quarter thought that even good mental health care was not effective.

The researchers tried to predict the costs of mental health care for the 1.6 million troops deployed since 2001. They estimated that costs related to post-traumatic stress disorder and serious depression were $4bn-$6.2bn (£2bn-£3.1bn; €2.5bn-€3.9bn) for two years in 2007 dollars. They also concluded that costs for the first year for cases of diagnosed traumatic brain injury in contact with the healthcare system could be $591m-$910m, also in 2007 dollars.

The report has four key recommendations:

• Increase the cadre of providers who are trained and certified to deliver care

• Change policies to encourage active personnel and veterans to seek needed care

• Deliver proved, evidence based care to service members and veterans whenever and wherever services are provided

• Invest in research to close information gaps and plan effectively

The US army colonel Loree K Sutton, director of the Defense Center of Excellence for Traumatic Brain Injury/Post Traumatic Stress Disorder, called it “heartening” that the study’s conclusions were “very consistent with previous studies by the army’s mental health advisory team and other results published in a private medical journal.”

She said that the military health community has used $500m appropriated in 2007 to fund more than 25 new programmes. She added, “We want to provide evidence based care, the very highest quality care.”