US must step up response to vets, report says

(HealthDay)—Timely and adequate health care is needed to help U.S. military personnel and their families readjust to life after deployment, an Institute of Medicine report finds.

The departments of defense and veterans affairs also must step up efforts to reduce the stigma associated with receiving care for mental health and substance abuse problems, the report said. They also should ensure their methods of diagnosis and treatment are in line with the latest medical evidence, according to the report, which was requested by Congress.

"Although several federal agencies are actively trying to address the support needs of current and former service members deployed to Iraq and Afghanistan, as well as their families, the response has been slow and has not matched the magnitude of this population's requirements as many cope with a complex set of health, economic and other challenges," report committee chairman George Rutherford said in an Institute of Medicine news release.

"The number of people affected, the influx of returning personnel as the conflicts wind down and the potential long-term consequences of their service heighten the urgency of putting the appropriate knowledge and resources in place to make re-entry into post-deployment life as easy as possible," Rutherford said.

More than 2.2 million U.S. troops have served in Iraq and Afghanistan, incurring more than 48,000 injuries and 6,600 deaths. Many troops have readjusted well to life after deployment, but 44 percent have reported difficulties since returning home, according the report.

A significant percentage have suffered traumatic brain injuries, and many have shown symptoms of post-traumatic stress disorder, depression and substance misuse or abuse, the report noted.

To better serve these troops, the Institute of Medicine, which is charged with providing policy makers, health care professionals and the public with independent, evidence-based advice, also concluded that:

• The VA and defense departments need to complete work as soon as possible on combined electronic medical records systems that will make it easier for current and former service members to access services and smooth the transition from one department to the other.
• Given the increase in the number of women in the military, the Department of Defense needs to boost its efforts to eliminate sexual harassment and assault. These problems, which affect a significant percentage of current and former female service members, can have long-term emotional and health consequences. One solution: Add criteria to commanding officers' performance reviews that assess how well they deal with sexual harassment and assault.
• Department of Defense support programs should address the needs of a full range of families, including unmarried partners, same-sex couples, single parents and stepfamilies. Those programs typically have focused on married, heterosexual couples and their children.
• As requested in 2010, the Veterans Health Administration should predict the amount and types of resources needed to meet the needs of veterans and their families in the next 30 years or more.