Mental Health Care for Iraq and Afghanistan War Veterans

1. Mental Health Care for Iraq and Afghanistan War Veterans Audrey Burnam, Lisa Meredith, Terri Tanielian, Lisa Jaycox

2. Few Veterans Who Need Mental Health Care Receive Even Minimally Adequate Treatment MH problem, no treatment MH problem, any treatment 8.8% MH problem, minimally adequate treatment 4.1% 5.6% No MH problem 81.5% SOURCE: T.L. Tanielian and L.H. Jaycox, (Editors). “Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery,” (pp. 101 & 103). RAND MG-720-CCF. Santa Monica, CA: RAND Corporation (2008). NOTES: MH is mental health. A MH problem is defined as meeting scoring criteria on a survey for probable diagnosis of PTSD or depression. Minimally adequate treatment is defined as at least 8 sessions averaging 30 minutes in duration for those reporting psychotherapy, and at least 4 visits with a doctor and staying on medication as long as the doctor recommended for those on medication over the prior year.

3. Key Challenges • Gaps in Access to Care • Veterans need care in their home communities, but it is not readily available in many parts of U.S. • Servicemembers often reluctant to seek care; military culture and institutions play a role • Gaps in Quality of Care • MH workforce often not trained to meet common core standards or competence in best practices • Organizational systems and tools to support quality improvement in mental health not widely used

4. What Else Can Be Done? • Confidential treatment options for servicemembers • Consumer education about treatment choices • MH workforce training and certification • Quality improvement systems and tools within DoD/Tricare • Technical assistance to states