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Brief Reports   |    
Prevalence of Mental Health Problems Among Iraq and Afghanistan Veterans Who Have and Have Not Received VA Services
Christine A. Vaughan, Ph.D.; Terry L. Schell, Ph.D.; Terri Tanielian, M.A.; Lisa H. Jaycox, Ph.D.; Grant N. Marshall, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300111
View Author and Article Information

The authors are with the Health Division of the RAND Corporation (e-mail: cvaughan@rand.org). Dr. Vaughan, Dr. Schell, and Dr. Marshall are in the Santa Monica, California, office, and Ms. Tanielian and Dr. Jaycox are in the Arlington, Virginia, office.

Copyright © 2014 by the American Psychiatric Association


Objective  Roughly half of veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) have not received services from the Veterans Health Administration (VHA). This study assessed probable posttraumatic stress disorder (PTSD) and depression among OEF/OIF veterans by receipt of VHA services.

Methods  In 2010 a mixed-mode survey assessing symptoms and VHA services utilization was fielded in a random sample of 913 New York State OEF/OIF veterans.

Results  Probable PTSD and depression were roughly three times more common among veterans who had received VHA services (N=537) (PTSD, 23%; depression, 21%) than those who had not (N=376) (PTSD, 6%; depression, 8%).

Conclusions  Studies of veterans receiving VHA services likely overstate the prevalence of mental health problems among the broader OEF/OIF veteran population. However, many veterans with mental health problems are not receiving VHA services. Policies that improve outreach to this population may improve health outcomes.

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Table 1Rates of probable PTSD and depression among 913 OEF/OIF veterans, by VHA service usea
Table Footer Note

a OEF/OIF, Operation Enduring Freedom and Operation Iraqi Freedom; VHA, Veterans Health Administration



Tanielian  T;  Jaycox  LH:  Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery .  Arlington, Va,  RAND Corp, 2008
Seal  KH;  Bertenthal  D;  Miner  CR  et al:  Bringing the war back home: mental health disorders among 103,788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities.  Archives of Internal Medicine 167:476–482, 2007
Seal  KH;  Metzler  TJ;  Gima  KS  et al:  Trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans using Department of Veterans Affairs health care, 2002–2008.  American Journal of Public Health 99:1651–1658, 2009
McNally  RJ:  Are we winning the war against posttraumatic stress disorder? Science 336:872–874, 2012
Ramchand  R;  Schell  TL;  Karney  BR  et al:  Disparate prevalence estimates of PTSD among service members who served in Iraq and Afghanistan: possible explanations.  Journal of Traumatic Stress 23:59–68, 2010
Analysis of VA Health Care Utilization Among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn Veterans. Washington, DC, Department of Veterans Affairs, Veterans Health Administration, Office of Public Health, 2012
Vaughan  CA;  Schell  TL;  Jaycox  LH  et al:  Quantitative needs assessment of New York State veterans and their spouses; in  A Needs Assessment of New York State Veterans: Final Report to the New York State Health Foundation . Edited by Schell  TL;  Tanielian  T.  Santa Monica, Calif,  RAND Corp, 2011. Available at www.rand.org/pubs/technical_reports/TR920.html.html
Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys, 7th ed. Deerfield, Ill, American Association for Public Opinion Research, 2011
Weathers  F;  Huska  J;  Keane  T:  The PTSD Checklist Military Version (PCL-M) .  Boston,  National Center for PTSD, 1991
Grieger  TA;  Cozza  SJ;  Ursano  RJ  et al:  Posttraumatic stress disorder and depression in battle-injured soldiers.  American Journal of Psychiatry 163:1777–1783, 2006
Weathers  FW;  Litz  BT;  Herman  DS  et al:  The PTSD Checklist (PCL): Reliability, Validity, and Diagnostic Utility .  San Antonio, Tex,  International Society for Traumatic Stress Studies, 1993
Brewin  CR:  Systematic review of screening instruments for adults at risk of PTSD.  Journal of Traumatic Stress 18:53–62, 2005
Kroenke  K;  Spitzer  RL;  Williams  JBW:  The PHQ-9: validity of a brief depression severity measure.  Journal of General Internal Medicine 16:606–613, 2001
Kroenke  K;  Strine  TW;  Spitzer  RL  et al:  The PHQ-8 as a measure of current depression in the general population.  Journal of Affective Disorders 114:163–173, 2009
VA Mental Health: Number of Veterans Receiving Care, Barriers Faced, and Efforts to Increase Access. Washington, DC, Government Accountability Office, 2011
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