Many Veterans Not Getting Enough Treatment for PTSD

/ Author:  / Reviewed by: Joseph V. Madia, MD

Although the Department of Veteran Affairs is rolling out treatments nationwide as fast as possible to adequately provide for newly diagnosed posttraumatic stress disorder (PTSD) patients, there are still significant barriers to veterans getting a full course of PTSD treatment.
This study is published in the February 2010 issue of the Journal of Traumatic Stress.

More than 230,000 Iraq and Afghanistan war veterans sought treatment for the first time at VA health care facilities nationwide between 2002 and 2008. More than 20 percent of these veterans, almost 50,000, received a new PTSD diagnosis. Treatments shown to be effective for PTSD typically require 10 to 12 weekly sessions. The VA follows these recommendations; however, fewer than 10 percent of those Iraq and Afghanistan veterans with newly diagnosed PTSD complete this recommended regimen of PTSD treatment. When the timeframe was expanded to a year rather than four months, fewer than 30 percent of the veterans completed the recommended course of treatment.

The study showed there are groups of veterans who are less likely to receive adequate care than others, such as male veterans (compared to female veterans), veterans under age 25, veterans who received their PTSD diagnoses from primary care clinics (requiring referral to a mental health program) and veterans living in rural areas.

Dr. Karen Seal, head researcher for the study and practitioner at the San Francisco Veteran Affairs Medical Center, says that while the majority of veterans with PTSD attend at least one mental health follow-up visit, there are still substantial barriers to care that prevent the majority from completing what is considered an adequate course of PTSD treatment. Many obstacles are system-level or are personal barriers resulting in a lack of patient follow-up on appointments, etc.

The study doesn't account for care that veterans may be receiving outside of the VA, such as care received at Vet Centers or other community-based clinics. The study concludes there is further need for the VA and other health care systems to develop new, innovative ways to overcome barriers to care in delivering these effective mental health treatments. The success of the VA's most recent efforts to enhance PTSD care cannot be determined from the study's findings, which cover the period through 2008 only.

Bethany Carland Adams

Reviewed by: 
Review Date: 
September 20, 2010