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Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.
Care of Military Service Members, Veterans, and Their Families serves a critical need, which has been highlighted by recent reported rates of combat-related stress disorders and traumatic brain injury, as well as increases in suicide rates among service members and veterans over the past decade and the distress and challenges faced by their children and families. More than 2.5 million Americans currently serve in the U.S. military on active duty, in the Reserves, or in the National Guard, and more than 20 million civilians are veterans. Although patients are viewed here in the context of military service, they seek health care in military, veteran, and civilian settings, and their mental health concerns are as diverse as those encountered in the civilian population. This book is designed for clinicians in all care settings and provides thorough coverage of U.S. military structures and cultures across the armed services, as well as detailed material on the particular mental health challenges faced by service members and their families. A full overview of the military lifestyle is provided, including the life cycle of the military (recruitment to retirement), service subcultures (Navy, Army, Marines, Air Force, and Reserve and Guard components), challenges of military life for service members and families (moves, deployments, etc.), and military mental health. Material on military culture provides insight for practitioners who may not be familiar with this population. The book focuses on collaborative care, particularly between the military health care system and the Veterans Administration, providing clinicians with strategies to mitigate stigma and other barriers to care through mental health service delivery in primary care settings. The incidence of traumatic brain injury among service members has increased because of the use of improvised explosive devices, and an entire chapter is devoted to diagnosing and treating these injuries as well as educating patients and their families on the condition. The families of service members face significant challenges, and several chapters are devoted to the needs of military children, the families of ill and injured service members and veterans, deployment-related care, and caring for the bereaved. The book's comprehensive review of resources available to military service members, veterans, and families both ensures high-quality care and reduces the workload for treating physicians. Care of Military Service Members, Veterans, and Their Families is an authoritative and much-needed addition to the mental health literature.
Problems stemming from the misuse and abuse of alcohol and other drugs are by no means a new phenomenon, although the face of the issues has changed in recent years. National trends indicate substantial increases in the abuse of prescription medications. These increases are particularly prominent within the military, a population that also continues to experience long-standing issues with alcohol abuse. The problem of substance abuse within the military has come under new scrutiny in the context of the two concurrent wars in which the United States has been engaged during the past decade-in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom and Operation New Dawn). Increasing rates of alcohol and other drug misuse adversely affect military readiness, family readiness, and safety, thereby posing a significant public health problem for the Department of Defense (DoD). To better understand this problem, DoD requested that the Institute of Medicine (IOM) assess the adequacy of current protocols in place across DoD and the different branches of the military pertaining to the prevention, screening, diagnosis, and treatment of substance use disorders (SUDs). Substance Use Disorders in the U.S. Armed Forces reviews the IOM's task of assessing access to SUD care for service members, members of the National Guard and Reserves, and military dependents, as well as the education and credentialing of SUD care providers, and offers specific recommendations to DoD on where and how improvements in these areas could be made.