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

Whenever I think about what my professional purpose is (the 3 x 5 card exercise), I say that it is to reduce disparities among vulnerable populations. It’s why I became a doctor. This study highlights the challenges of an important vulnerable population.

Milliken CS, Auchterlonie JL, Hoge CW. Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning From the Iraq War. Jama 2007;298:2141-8.

Here are some thoughts I had on how to help:

1. Involvement of family. I have used the after visit summary to inform family members who aren’t or can’t be in the care environment about what happened in the clinical encounter. I note that this is a challenge of the military system, that families cannot be involved as they would like.

2. Destigmitization. I did not know that behavioral health care is not confidential in the military as opposed to civilian life. The paper indicated that the screening in and of itself is a form of Information Therapy. Is there an opportunity to make the fact that this is a medical condition more clear to commanders and patients.

3. Longitudinal management. The paper indicated that those who entered treatment did worse than those who did not. This is explained in many ways, but most interesting is the explanation that the visits are just points in time, with no continuous engagement or self-management. It seems that many improve on their own, and is there a role for information along the way to speed up that improvement so people can return to achieving their life goals?

As you will see from Photo Friday this week, there are very tangible reminders in this community about what this means for the people we serve as health professionals, as they serve us.

1 Comment

[…] The PCHIT Initiative broadens this view of vulnerable populations to include those with documented disparities including but not limited to individuals who are lesbian, gay, bisexual, and transgender. An additional vulnerable population of interest are returning soldiers (see: Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Return…). […]

Ted Eytan, MD