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When soldiers return from the war in Iraq, it often takes several months for mental health problems to show up. A new study by the Army finds those problems are more likely to be diagnosed after some time. The study also indicates mental health issues are putting even more stress on the military and V.A. health care system.
NPR's Joseph Shapiro has been looking at the research in the Journal of the American Medical Association.
JOSEPH SHAPIRO: A lot of soldiers come home from Iraq with mental health problems, but the new research shows that those problems really don't start showing up until several months after they have been back. After six months, soldiers are four times more likely to say they're having what the researchers call interpersonal conflict. That means things like fighting with a spouse, children and other family members, or having a hard time getting along with friends or a boss at work. Other problems, too, grow after several months, like alcoholism, depression and post-traumatic stress disorder.
Army psychiatrist Charles Milliken is co-author of the research.
Dr. CHARLES MILLIKEN (Psychiatrist, Walter Reed Army Institute of Research, Division of Psychiatry and Neuroscience): What the study shows is if you look for some earlier version of those problems, whether it'd be depression or PTSD or some relationship problems, that we can find it within six months of the soldiers coming home from war.
SHAPIRO: When soldiers come back from Iraq, they fill out a seven-page health care survey. The new research says that first survey doesn't catch most problems. It may be that soldiers who've just come home are feeling good and they're anxious to get back to friends and family. Either they don't realize they're having mental health problems, they don't want to admit them, or hope they'll go away. So two years ago, the Pentagon added a second survey, three to six months after troops got home.
That's where Dr. Milliken found the problem showing up.
Dr. MILLIKEN: Just the process of being asked twice - how's your psyche, how are your relationships - it sends a message that, you know, stress is a natural part of combat. And some people may need a little extra help getting over it once they're home. And if you need a little extra help, go get it. Get help early before it affects your health, before it affects your relationships.
SHAPIRO: Earlier studies by Milliken and other researchers at the Walter Reed Army Institute of Research showed that about one in seven soldiers develop PTSD. The new study shows that a lot are getting care for some kind of mental health problem within the first six months - about 20 percent of active duty soldiers and 42 percent of members of the National Guard and Reserve.
The high number of problems among Guard and Reserve was new. That puzzled Milliken.
Dr. MILLIKEN: When you look three to six months later, they do have more mental health concerns, but they also have higher physical health concerns. So that makes us think that this may be a difference in health coverage.
SHAPIRO: Members of the Guard and Reserve get health care from the Pentagon, but it runs out six months after they come home, so many may be declaring their mental health problems before that coverage disappears. They also get access to the V.A. health care system for two years.
Milliken's study notes that other reports have found that the Pentagon's mental health system is overburdened, understaffed and needs more money.
Paul Rieckhoff of the veterans' group Iraq and Afghanistan Veterans of America says the new report shows that care has to be a lot more extensive.
Mr. PAUL RIECKHOFF (Executive Director and Founder, Iraq and Afghanistan Veterans of America): We need mandatory face-to-face counseling sessions for every single soldier coming home, we need follow-up counseling sessions for those family members and the soldiers, and we need to be more innovative. We need to be more proactive. We need a V.A. that's less passive, that reaches out into the communities, and finds those veterans and make sure that they're doing all right.
SHAPIRO: Veterans groups see a glass half-empty. They point to recent reports of more suicides and more homeless veterans. The new report sees a glass half-full. A lot of soldiers and their families are recognizing mental health problems and are seeking help.
Joseph Shapiro, NPR News.
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