Recent trends in the treatment of posttraumatic stress disorder and other mental disorders in the VHA.

OBJECTIVE

This study proposed to evaluate Veterans Health Administration (VHA) specialty mental health care workload for treating posttraumatic stress disorder (PTSD) and other mental disorders between 2005 and 2010 in comparison with results from 1997 to 2005. The 2005-2010 time frame represents a period of increased utilization of services by recently returning veterans and of program expansion within VHA.

METHODS

VHA administrative databases were queried for all veterans receiving specialty mental health treatment annually between 2005 and 2010. Veterans were categorized by military service era (WWII or Korea, Vietnam, post-Vietnam, Persian Gulf War [including operations in Iraq and Afghanistan], and peacetime or other), diagnosis (PTSD or a non-PTSD mental disorder), and deployment to Iraq or Afghanistan.

RESULTS

The total number of veterans served per year increased by 623,326 (117.6%) between 1997 and 2010. Veterans with PTSD increased at a greater rate since 2005 compared with veterans with other mental disorders. Vietnam veterans constituted a majority of all veterans treated for PTSD or for other mental disorders, and the number of Vietnam veterans treated for PTSD continues to grow. The number of visits per veteran with PTSD increased between 2006 and 2010, reversing previous trends. The rate of increase has been highest for Iraq and Afghanistan veterans.

CONCLUSIONS

Both the number treated and treatment intensity have increased for veterans with PTSD who served in current conflicts, which might be expected, and in the Vietnam era, now 30 years past. A reversal of past declines in treatment intensity coincides with an increase in PTSD treatment funding and program expansion since 2005.