Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning From the Iraq War.

摘要

Described the Department of Defense's (DoDs) screening efforts to identify mental health concerns among soldiers and Marines as they return from Iraq and Afghanistan using the Post-Deployment Health Assessment (PDHA). However, the article also raised concerns that mental health problems might be missed because of the early timing of this screening. It cited preliminary data showing that soldiers were more likely to indicate mental health distress several months after return than upon their immediate return. 2,3 Based on these preliminary data, the DoD initiated a second screening similar to the first, to occur 3 to 6 months after return from deployment. 4 This report reviews the mental health responses of the first cohort of soldiers to complete both the PDHA and the new Post-Deployment Health Re-Assessment (PDHRA) after return from the Iraq war. Because of the longitudinal focus of the study, we included soldiers only from the Iraq war (not from Afghanistan), the larger cohort with the most consistently high rates of combat exposure. We addressed several questions regarding the 2 screening programs: (1) Overall, what percentage of veteran soldiers of the Iraq war were identified as having clinically significant mental health problems and are rates higher on the PDHRA than on the PDHA; (2) As the UK experience suggests,5 are there differences in health concerns between soldiers still on active duty (active component) and reserve component veterans (National Guard and Army Reserve) who have returned to civilian life; (3) Are soldiers endorsing and being referred for alcohol problems; (4) What percentage of soldiers referred for mental health problems get care; (5) What percentage who indicate mental health problems on the PDHA improve by the time of the PDHRA, and is improvement associated with referral and receiving care.