A Needs Assessment of New York State Veterans: Final Report to the New York State Health Foundation, Summary

Mental health disorders and other types of impairments resulting from deployment experiences are beginning to emerge, but fundamental gaps remain in our knowledge about the needs of veterans returning from Iraq and Afghanistan, the services available to meet those needs, and the experiences of veterans who have tried to use these services. The current study focuses directly on the veterans living in New York state; it includes veterans who currently use U.S. Department of Veterans Affairs (VA) services as well as those who do not; and it looks at needs across a broad range of domains. The authors collected information and advice from a series of qualitative interviews with veterans of Operation Iraqi Freedom (OIF)/Operation Enduring Freedom (OEF) residing in New York, as well as their family members. In addition, they conducted a quantitative assessment of the needs of veterans and their spouses from a sample that is broadly representative of OEF/OIF veterans in New York state. Finally, they conducted a review the services currently available in New York state for veterans. The study found substantially elevated rates of post-traumatic stress disorder (PTSD) and major depression among veterans. It also found that both VA and non-VA services are critically important for addressing veterans' needs, and that the health care systems that serve veterans are extremely complicated. Addressing veterans' mental health needs will require a multipronged approach: reducing barriers to seeking treatment; improving the sustainment of, or adherence to, treatment; and improving the quality of the services being delivered. Finally, veterans have other serious needs besides mental health care and would benefit from a broad range of services

Views from the Homefront: The Experiences of Youth and Spouses from Military Families

As the United States continues deployments of service members to support operations in Iraq and Afghanistan, it is increasingly important to understand the effects of this military involvement, not only on service members but also on the health and well-being of their children and spouses. The purpose of this report is to examine the functioning of a sample of youth in military families who applied to a free camp for children of military personnel and to specifically assess how these youth are coping with parental deployment. The report addresses the general well-being of military youth during and after parental deployment, with attention to their emotional, social, and academic functioning. It also examines the challenges that their nondeployed caregivers face. The study includes quantitative and qualitative components: three waves of phone surveys with youth and nondeployed caregivers, and in-depth interviews with a subsample of caregivers. The researchers found that children and caregivers who had applied to attend the camp confronted challenges to their emotional well-being and functioning. Four factors in particular (1) poorer caregiver emotional well-being, (2) more cumulative months of deployment, (3) National Guard or Reserve status, and (4) poor quality of family communication were strongly associated with greater youth or caregiver difficulties

Post-Deployment Stress: What Families Should Know, What Families Can Do

Information is covered for families of veterans returning from deployment in Iraq or Afghanistan about post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), and other emotional and behavioral problems that veterans may face. Before developing this pamphlet, companion to CP-534-IADIF (Post-Deployment Stress: What You Should Know, What You Can Do), RAND surveyed a couple hundred existing educational materials on these topics. The researchers then coded and classified these materials and reviewed them to identify gaps in information and to isolate the best materials from which to draw upon. Based on these refined materials, the booklet was further improved by feedback from RAND Corporation experts, other military mental health experts, and nine focus groups including service members and their families

Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery

Since October 2001, approximately 1.64 million U.S. troops have been deployed for Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) in Afghanistan and Iraq. Early evidence suggests that the psychological toll of these deployments may be disproportionately high compared with the physical injuries of combat. Research has focused primarily on three conditions: post-traumatic stress disorder (PTSD), depression, and traumatic brain injury (TBI). Karney et al. review the empirical literature on these three conditions, focusing on research that supports projections about the likely outcomes for OEF/OIF veterans and their families. These include an increased risk of suicide, substance abuse, and cardiovascular disease. Mental health conditions among veterans are also associated with reduced work productivity and future job prospects and may be a precursor to homelessness. Post-combat mental health disorders also affect servicemembers' spouses and children: For example, each of the three disorders has been linked to intimate partner violence and divorce. The authors also emphasize that it is common for veterans with one of the three conditions -- PTSD, depression, or TBI -- to also develop another of the three, and such individuals tend to experience more severe symptoms, poorer treatment outcomes, and more disability in social and occupation function. Karney et al. conclude with two series of recommendations: one for future research, and one for policy and interventions to mitigate the consequences of post-combat mental health conditions