recommended reading

IOM Report: Defense/VA Have No Clue if $9.3 Billion Worth of PTSD Treatment Works

U.S. soldiers patrol the outskirts of Spin Boldak, near the border with Pakistan, about 100 kilometers (63 miles) southeast of Kandahar, Afghanistan.

U.S. soldiers patrol the outskirts of Spin Boldak, near the border with Pakistan, about 100 kilometers (63 miles) southeast of Kandahar, Afghanistan. // Emilio Morenatti/AP

The Defense and Veterans Affairs departments spent $9.3 billion to treat post-traumatic stress disorder from 2010 through 2012, but neither knows whether this staggering sum resulted in effective or adequate care, the Institute of Medicine reported today.

DOD spent $789.1 million on PTSD treatment from 2010 through 2012. During that same time period, VA spent $8.5 billion, with $1.7 billion treating 300,000 Iraq and Afghanistan veterans.

DOD lacks a mechanism for the systematic collection, analysis and dissemination of data for assessing the quality of PTSD care, and VA does not track the PTSD treatments a patient receives, other than medications, in its electronic health record, IOM said in the congressionally mandated 301-page report, “Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment.”

IOM estimated 5 percent of all service members have PTSD. Eight percent of those who served in Iraq and Afghanistan have been diagnosed with the condition. The number of veterans of all eras who sought care from VA more than doubled from 2003 to 2012 -- from approximately 190,000 veterans (4.3 percent of all VA users) in 2003 to more than a half million veterans (9.2 percent of all VA users) in 2012.

For those treated for PTSD in the VA system in 2012, 23.6 percent (119,500) were veterans of the Iraq and Afghanistan wars. 

Sandro Galea, professor and chair of the department of epidemiology in the Mailman School of Public Health at Columbia University and chairman of the IOM committee that produced the PTSD report, questioned the lack of hard data on the effectiveness of PTSD treatment in both departments.

 “Given that the DOD and VA are responsible for serving millions of service members, families and veterans, we found it surprising that no PTSD outcome measures are used consistently to know if these treatments are working or not," he said.

IOM also questioned the structure and organization of treatment programs in both departments. Treatment in the Military Health System “appears to be local, ad hoc, incremental and crisis-driven, with little planning devoted to the development of a long-range approach to obtaining desired outcomes.”

DOD has a universal electronic health record, but no attempt has been made to use it to assess PTSD treatment outcomes in the aggregate, and purchased care providers outside the Military Health System cannot access it, IOM said.

VA, IOM said, has a more unified organizational structure for its PTSD treatment programs, but “without data on which treatments patients are receiving and whether they are improving as a result of their treatment, the departments have no way of knowing whether the care they are providing is effective or whether DOD and VA's expenditures are resulting in high-value health care.” 

VA is modifying its electronic health record system to capture the psychotherapy each patient receives, IOM reported.

IOM recommended DOD and VA develop an integrated, coordinated and comprehensive PTSD management strategyuse standard metrics to screen for, measure and track PTSD symptoms and use a health information technology system that documents a patient’s PTSD treatments and progress so the data can be aggregated at the provider, program, facility, service, regional and national levels.

Threatwatch Alert

Thousands of cyber attacks occur each day

See the latest threats


Close [ x ] More from Nextgov

Thank you for subscribing to newsletters from
We think these reports might interest you:

  • Modernizing IT for Mission Success

    Surveying Federal and Defense Leaders on Priorities and Challenges at the Tactical Edge

  • Communicating Innovation in Federal Government

    Federal Government spending on ‘obsolete technology’ continues to increase. Supporting the twin pillars of improved digital service delivery for citizens on the one hand, and the increasingly optimized and flexible working practices for federal employees on the other, are neither easy nor inexpensive tasks. This whitepaper explores how federal agencies can leverage the value of existing agency technology assets while offering IT leaders the ability to implement the kind of employee productivity, citizen service improvements and security demanded by federal oversight.

  • Effective Ransomware Response

    This whitepaper provides an overview and understanding of ransomware and how to successfully combat it.

  • Forecasting Cloud's Future

    Conversations with Federal, State, and Local Technology Leaders on Cloud-Driven Digital Transformation

  • IT Transformation Trends: Flash Storage as a Strategic IT Asset

    MIT Technology Review: Flash Storage As a Strategic IT Asset For the first time in decades, IT leaders now consider all-flash storage as a strategic IT asset. IT has become a new operating model that enables self-service with high performance, density and resiliency. It also offers the self-service agility of the public cloud combined with the security, performance, and cost-effectiveness of a private cloud. Download this MIT Technology Review paper to learn more about how all-flash storage is transforming the data center.


When you download a report, your information may be shared with the underwriters of that document.