Iraq Veterans Experience Delayed Mental Stress

Soldiers who served in Iraqare experiencing much greater mental distress three to six months after leavingthe war zone than when they first returned to the U.S., according to a Walter Reed Army Institute of Research/U.S. Army Center for Health Promotion andPreventive Medicinestudy published in the Journal of the American Medical Association,the Washington Post reports. For the study, researchers analyzed questionnaires completedby 88,235 Iraq War soldiers. About 56,000 of the respondents remain on activeduty, while 32,000 are in the Army Reserve or National Guard. Ninety percent of the questionnaires werecompleted by men, 60% of whom were married (Scott Tyson, Washington Post,11/14).

Overall, almost one-third of the servicemembers had signs of depression,post-traumatic stress disorder, conflicts in relationships and other mentalhealth problems six months after leaving Iraq, the study found (Johnson, AP/Long Island Newsday, 11/13). According to the study,soldiers were far more likely to report problems such as PTSD and conflictswith family or friends during a screening performed three to six months afterreturning from Iraqcompared with an assessment taken immediately upon their return (WashingtonPost, 11/14).

Paul Reickhoff, executive director of Iraq and Afghanistan Veterans ofAmerica, said that in the initial screening, soldiers might have minimizedconcerns so they would not be delayed in returning home. In addition, there isa "honeymoon period" upon returning home that lasts until negativeexperiences begin to sink in, according to the LosAngeles Times(Maugh, Los Angeles Times, 11/13). Stephen Jones, an Armyassistant surgeon general, said, "When you come back, ... you're almosteuphoric, ... you don't have any problems in the world," but after sometime has passed, "the stress starts to resurface."

Problems Reported MoreAmong Reservists Than Active Duty

The study also foundNational Guard members and reservists reported mental health problems at higherrates than active-duty troops. Based on the two screenings -- one occurringimmediately upon return and one occurring up to six months later -- one in fiveactive-duty Army soldiers and more than 40% of Army reservists were identifiedas being in need of treatment for their mental distress. During the secondscreening, 24.5% of reservists reported concerns with PTSD, compared with 16.7%of active-duty soldiers; 13% of reservists reported depression concerns,compared with 10.3% of active servicemembers; and 35.5% of reservists wereconcerned about their risk of developing mental health problems, compared with27.1% of active-duty soldiers.

In addition, nearly 12% of active-duty soldiers and 15% of reservists reportedabusing alcohol, yet less than 1% were referred for substance-abuse treatment,possibly due to concerns about treatment records not being confidential,according to the study. According to the Post, reservists mightexperience more mental health problems because of the adjustment to civilianlife without the daily support of their "war-zone comrades" (WashingtonPost, 11/14). In addition, Reickhoff said, reservists and National Guardmembers might be more willing to admit to mental health problems thanactive-duty military members because of perceived stigma (Los AngelesTimes, 11/14).

Recommendations

Researchers recommendedthat the Army provide mental health care services to veterans and their familymembers "before symptoms become chronically entrenched" (WashingtonPost, 11/14). Treating mental illness early can help prevent long-termproblems, according to lead researcher Charles Milliken of Walter Reed (LosAngeles Times, 11/13).

However, the study also questions the effectiveness of PTSD treatment in the"overburdened" military medical system, finding "no directrelationship of referral or treatment with symptom improvement" (WashingtonPost, 11/14).

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