August 22, 2013
The Congressional Research Service just put a price tag on the mental health costs of the long wars in Afghanistan and Iraq: about $4.5 billion between 2007 and 2012. The Defense Department spent $958 million on mental health treatment in 2012, roughly double the $468 million it spent in 2007.
Overall, approximately 63 percent of mental disorder treatment costs were for outpatient treatment, 31 percent for for inpatient treatment, and 7 percent for pharmacy costs, CRS said.
These costs reflect grim underlying statistics, according to the Aug. 8 report, “Post-Traumatic Stress Disorder and Other Mental Health Problems in the Military: Oversight Issues for Congress.” Steven Aftergood of the Federation of American Scientists obtained and posted it on his Secrecy News Blog today.
Between 2001 and 2011, the rate of mental health diagnoses among active duty service members increased approximately 65 percent, CRS reported. A total of 936,283 service members, or former service members during their period of service, have been diagnosed with at least one mental disorder over this time, CRS said.
The CRS report, written by Katherine Blakeley, a foreign affairs analyst, and Don J. Jansen, a Defense health care policy analyst, said the reported incidence of post traumatic stress disorder soared 650 percent, from about 170 diagnoses per 100,000 person years in 2000 to approximately 1,110 diagnoses per 100,000 person years in 2011.
During the same time period, alcohol abuse and dependence incidence rates per 100,000 person years fell 20.2 percent and substance abuse and dependence rates increased 28.5 percent.
The Army, followed by the Marine Corps, has consistently had the highest incidence rates for PTSD, major depression, alcohol dependence, and substance dependence between 2007 and 2010, followed by the Navy and the Air Force, CRS said.
Troops experienced about 255,852 traumatic brain injuries -- considered the “signature injury” of the Afghanistan and Iraq wars -- but the report noted that 80 percent of those injuries occurred in non-deployed settings, including vehicle crashes, falls, sports and recreation activities and training.
This included 212,741 incidences of mild TBI; 20,168 incidences of moderate TBI; 6,472 incidences of severe TBI or penetrating head injuries; and 16,471 that were unclassifiable.
Though Defense spent $4 billion on mental health treatment for active duty service members from 2007 through 2012, the CRS report questioned exactly what the Pentagon got for its money. “There are scant data documenting which treatments patients receive or whether those treatments were appropriate and timely,” the report said.
The researchers said Congress may want “to examine the question of whether DOD is ensuring optimal means of access to and assignment of mental health care providers,” as well as the effectiveness of initiatives to reduce the stigma associated with mental health treatment and encourage service members to seek care.
Faced with spiraling military health care costs, the CRS report also suggested Congress “may wish to examine the role of supplying larger amounts of mental health care in the context of the Defense Health Program appropriation since growth in the unified medical budget relative to the overall Defense budget has been identified by some senior leaders as unsustainable.”
This story has been updated.
August 22, 2013