Publication year
2010
Citation Title
Reintegration problems and treatment interests among Iraq and Afghanistan combat veterans receiving VA medical care.
Journal Name
Psychiatric Services
Journal Volume
61
Issue Number
6
Page Numbers
589-597
DOI
10.1176/appi.ps.61.6.589
Summary
The researchers assessed the prevalence and types of community reintegration problems among Iraq and Afghanistan combat Veterans, as well as their interest in various treatments. Between 25-56% of the Veterans reported some to extreme difficulty in several areas of reintegration; almost all (96%) reported interest in services to address these problems.
Key Findings
Based on VA records, 26% of the Veterans had a diagnosis of PTSD, 28% depression, 5% substance. Based on survey screening measures, 39% had probable PTSD and 35% probable drug or alcohol problems.
Fifty-seven percent of the Veterans reported problems controlling their anger since coming home from deployment, 35% reported driving dangerously, and 35% reported divorce or separation.
Forty percent of the Veterans perceived some to extreme difficulty in readjusting to civilian life within the previous 30 days.
Ninety-six percent of the Veterans reported interest in services for community reintegration problems; the average number of services they considered using was 6.84 out of 12 options (i.e., information on benefits and schooling, self-educational materials, and medication).
Implications for Program Leaders
Offer workshops to help Service members and their families adjust following a deployment
Disseminate information regarding services available to Service members and their families throughout the deployment cycle
Educate Service members and their families regarding the possible mental health issues associated with deployment
Implications for Policy Makers
Support programs that offer web-based integration strategies which could reach a broad array of Service members interested in assistance with reintegration
Continue to support programs that help Service members cope with functional problems, including driving concerns, help with schooling, and medication management assistance
Encourage collaboration between DoD and community-based services that provide Service members and their families with mental health support throughout the deployment cycle
Methods
Stratified random sampling was used to identify 1,500 Veterans from different geographic areas who represented different racial and gender groups.
Veterans were contacted via mail with a five dollar incentive.
Questionnaire included questions regarding demographics, physical and mental health, perceived community reintegration problems, and treatment interests and preferences.
Participants
Participants included 754 Iraq and Afghanistan combat Veterans from all service branches who made at least one visit to a VA hospital from October 2003-July 2007.
The majority of participants were female (55%), White (51%), and between the ages of 22-29 years (42%) or 30-39 years (30%).
Fifty-three percent of participants were Reserves or National Guard, 52% noncommissioned officer, 36% junior enlisted; 74% were from the Army, 11% from the Navy, 7% from the Air Force, and 7% were Marines.
Limitations
Important differences between survey responders and non-responders could have existed which may have biased these results.
The sample included only Iraq-Afghanistan combat Veterans who had used VA services and may not translate to those who had not yet used VA services.
The use of screening measures for probable mental health issues are not always accurate and may bias results.
Avenues for Future Research
Examine how interest in help translates to help-seeking or use of services
Explore whether evidence-based treatment for PTSD leads to improvements in functional and readjustment outcomes
Assess differences in community reintegration problems based on psychiatric disorders other than PTSD
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Objective: The objectives of this study were to describe the prevalence and types of community reintegration problems among Iraq and Afghanistan combat veterans who receive U.S. Department of Veterans Affairs (VA) medical care, identify interests in interventions or information to promote readjustment to community life, and explore associations between probable posttraumatic stress disorder (PTSD) and reintegration problems and treatment interests. Methods: A national, stratified sample of Iraq-Afghanistan combat veterans receiving VA medical care responded to a mailed survey focused on community reintegration. Of 1,226 veterans surveyed, 754 (62%) responded. Prevalence and proportions were adjusted for potential nonresponse bias. Results: An estimated 25% to 56% of combat veterans who use VA services reported "some" to "extreme" difficulty in social functioning, productivity, community involvement, and self-care domains. At least one-third reported divorce, dangerous driving, increased substance use, and increased anger control problems since deployment. Almost all (96%) expressed interest in services to help readjust to civilian life (95% confidence interval [CI]=93%–99%). The most commonly preferred ways to receive reintegration services or information were at a VA facility, through the mail, and over the Internet. An estimated 41% (95% CI=36%–46%) screened positive for PTSD, and probable PTSD was associated with reporting more readjustment difficulties and expressing interest in more types of services, including traditional mental health services. Conclusions: Iraq-Afghanistan combat veterans who already receive VA medical care reported multiple current reintegration problems and wanted services and information to help them readjust to community life. These concerns were particularly prevalent among those with probable PTSD. Research is needed to explore nontraditional modes of service delivery, including the Internet.
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