Article2010

Reintegration Problems and Treatment Interests Among Iraq and Afghanistan Combat Veterans Receiving VA Medical Care

Nina Aileen Sayer · Siamak Noorbaloochi · Patricia A. Frazier · Kathleen Ferguson Carlson · Amy A. Gravely · Maureen Murdoch

527 citations0/0 files storedPsychiatric Services

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Education and Military Integration Posttraumatic Stress Disorder Research Migration, Health and Trauma

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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References

1995Posttraumatic Stress Disorder in the National Comorbidity Survey 2004Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care 2006Mental Health Problems, Use of Mental Health Services, and Attrition From Military Service After Returning From Deployment to Iraq or Afghanistan 2007Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning From the Iraq War 2004The primary care PTSD screen (PC–PTSD): development and operating characteristics 2000Quality of Life in Individuals With Anxiety Disorders 2005Quality-of-Life Impairment in Depressive and Anxiety Disorders 2009Trends and Risk Factors for Mental Health Diagnoses Among Iraq and Afghanistan Veterans Using Department of Veterans Affairs Health Care, 2002–2008

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2015The efficacy of recommended treatments for veterans with PTSD: A metaregression analysis 2015Prevalence of, Risk Factors for, and Consequences of Posttraumatic Stress Disorder and Other Mental Health Problems in Military Populations Deployed to Iraq and Afghanistan 2014Warring Identities 2011Military to civilian questionnaire: A measure of postdeployment community reintegration difficulty among veterans using Department of Veterans Affairs medical care

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