on the other hand, Hospitalization rate for active duty soldiers There is an overall decreasing trend In the wake of the wars in Iraq and Afghanistan, As mental health infections spread across the country, mental health-related hospitalizations and even evacuations from deployed locations are on the rise.
According to new survey data from the U.S. military’s monthly medical surveillance report. In our summer issue, we charted military medical provider encounters and hospitalizations from 2018 to 2022, and also tracked five-year trends in non-combat military medical evacuations.
Some trends are dramatic. U.S. Central Command, a region that includes the Middle East, has seen a significant increase in medical evacuations due to mental health disorders each year since 2019.
In 2022, 38.8% of evacuations from Central Command were mental health related, compared to 33.5% in 2021 and 27.2% in 2020. Of these, 268 soldiers were evacuated from the Central Command due to mental illness. . Mental health-related incidents were the largest evacuation category in Central Command in 2022.
In U.S. Africa Command, the overall rate of medical evacuations will sharply increase in 2022 due to changes in the global military structure, but mental health will account for 14.8% of medical evacuations compared to 30.1% for “non-combat injuries and poisonings.” It was the second most common after. . Out of a total of 229 evacuees from Africa Command in 2022, 34 service members were evacuated due to mental illness.
By comparison, the mental health evacuation rate from Iraq was 11.6% over the nine-year period from 2003 to 2011, about one-third of the current rate, according to monthly medical surveillance data.
According to reporting standards, all soldiers were evacuated to the United States or Europe and seen by a health care provider for further treatment.
There has also been an overall increase in in-theater medical procedures due to mental health disorders. These increased from 4.4% to 6.2% over the five-year study period, with “adjustment disorder, a combination of anxiety and depressed mood” topping the list of mental health conditions requiring medical attention.
U.S. data shows that from 2018 to 2022, hospitalization rates and numbers among active duty and reservists decreased “in all major diagnostic categories except mental health disorders.” They increased slightly from 5.7% to 5.9%.
Survey data showed that mental health disorders were the top reason for hospitalization each year, with 19,079 people hospitalized in 2022, more than 1,000 more than the 18,012 in 2018.
During the same period, hospitalizations for injuries and poisonings fell by nearly 1,600. And those related to musculoskeletal problems decreased by nearly 1,700. The total number of hospitalizations for all conditions fell nearly 14%, he said, from 66,128 to 57,009.
Outpatient visits for mental health problems (not requiring hospitalization) were only the third most common category for service members after “other” and musculoskeletal problems, but outpatient visits for mental health problems Attendance rates have increased dramatically.
The number of mental health-related outpatient visits increased by 20% from 2018 to 2022, from 1.9 million to 2.3 million. Again, adjustment disorders were the top category for these visits.
The rise in military mental health issues requiring treatment and intervention is not occurring in a vacuum.
Estimation 1 in 5 American adults Currently suffering from mental illness, caused by the coronavirus pandemic global increase According to the World Health Organization, the prevalence of behavioral health conditions such as anxiety and depression is approximately 25%.
Kimberly Kepner, Ph.D., a senior behavioral scientist at Rand University, said the increased number of medical provider visits for mental illnesses in the military is not necessarily a bad thing. This speaks to military and civilian efforts to destigmatize the process of seeking treatment and establish an understanding that “mental health care is health care,” she said.
She said the stressors and shared experiences of COVID-19 contributed to that mindset shift.
Meanwhile, the increase in mental health-related evacuations of deployed troops represents a clear concern, Kepner said.She made a point that is widely acknowledged Shortage of mental health providers in the military it is There is a national shortage of behavioral health physicians..
Because of this shortage, more soldiers are receiving behavioral health care from the private sector through private health care providers contracted with the military’s TriCare health system, she said. While this is a better solution than leaving mental health needs unmet, these contracted providers are unlikely to understand implementation readiness requirements, she said.
“If I were sitting in a military training facility, assessing readiness at every session would be my bread and butter,” she said. “But providers in the community may not understand these issues either. They may be meeting service members for the first time and may not be as familiar with the need to assess readiness.”
As a result, service members who are not psychologically healthy enough to handle the stressors of deployment may often be allowed to deploy, she said. And she said this is a serious concern because it disrupts the military’s ability to effectively carry out its frontline missions.
According to a recent medical surveillance monthly report, the most common diagnosis associated with medical evacuations from Central Command and African Command in 2022 was “reaction to severe stress and maladjustment.”
“Depressive episodes,” “recurrent major depressive disorder,” and “other anxiety disorders” also ranked high on the list.
To Hepner, the obvious solution is to increase the number of behavioral health providers within military treatment facilities, but she acknowledged that process could take time. She also said the military likely needs to better understand the background and precursors to these mental health-related medical evacuations and consider existing efforts to screen and assess troops before deployment. Stated.
“The readiness assessment at this point is very extensive, but something may be missed at that stage,” she said. “So that begs the question, how can we improve that process?”
As all militaries face historic challenges in meeting their recruiting goals, some are exploring ways to accommodate future enlistees with a history of mental health issues.
The Army changed its policy in 2018 to allow potential recruits under the age of 14 with a history of self-harm. Some lawmakers are now pushing to completely eliminate the exclusion for potential recruits who have sought mental health care in the past.
Hepner said it’s important to remember that mental health care visits and hospitalizations do not preclude a return to full health and functional capacity; in fact, they are a common outcome of behavioral health treatment. said that it is important.
“This is care that all service members should have access to, and we want to continue to emphasize that access to quality behavioral health care helps service members return to full duty and complete their missions. ” she said. “And we want to help them do that.”
Hope Hodge Seck is an award-winning investigative and corporate reporter covering the U.S. military and national defense. A former editor-in-chief of Military.com, her work has also appeared in the Washington Post, Politico Magazine, USA Today, and Popular Mechanics.