Brandeis researchers to investigate health treatment, problems of combat vets

A four-year, $1.8 million study of Army personnel in Iraq and Afghanistan

Mary Jo Larson

Brandeis University researchers will investigate combat-related psychological problems and missed treatment opportunities among Army personnel returning from Iraq and Afghanistan in a new national study.

The university has been awarded $379,000 in fiscal year 2010 — and a total of nearly $1.8 million over four years — for the study, which will look at combat-related psychological problems of returning veterans using self-reports and problems noted by professionals at routine, mandatory screening interviews. The study then will investigate the immediate response of military healthcare providers to these problems and, in turn, the soldiers’ access to and receipt of needed behavioral health care.

The study’s ultimate aim is to determine the relationship of early problem identification and healthcare use to positive health outcomes, and the extent to which absence of early identification and treatment are correlated to development of alcohol- and drug-use disorders, post-traumatic stress disorder (PTSD), other psychological disabilities and ongoing behavioral problems such as violence or suicidal threats and actions that result in attrition from the armed forces.

“We saw a need for a longitudinal study of immediate signs and symptoms of combat problems that linked healthcare services after deployment to later emergence of chronic problems. That kind of research is absent from the current scientific literature, said Mary Jo Larson, principal investigator and senior scientist of the Institute for Behavioral Health at Brandeis University’s Heller School for Social Policy and Management.  “We proposed a unique study that will combine records kept in different data silos of the military health system and Veterans Administration (VA).

“We will profile the activities of military and VA service locations, identify those that have the best pattern of health service use, and compare how those service profiles relate to later problem resolution and psychological recovery among service members returning from combat zones,” Larson said. “If we can demonstrate that certain healthcare responses are associated with greater resilience and recovery from combat stress, then the study’s findings will be useful for improving the military’s investment in healthcare services.”

Military personnel who have been deployed to Iraq and Afghanistan have been shown to be at increased risk of developing substance-use disorders, PTSD, and other psychological health problems. Despite signs that one-third to one-half of personnel returning from combat may have experienced psychological injury, the military is concerned that many soldiers avoid discussion of psychological complaints, are not referred, and are unable to access needed treatment.

The grant is funded by the National Institute on Drug Abuse (NIDA) and the project is sponsored by the TRICARE Management Activity/Department of Defense. To carry out the work, Brandeis has subcontracts with the Palo Alto Institute for Research and Evaluation (the Veterans Administration, Palo Alto CA) and Kennell and Associates, Inc. of Bethesda, MD.

The analyses will provide operationally actionable data useful to quality improvement programs in the military health system and VA on urgent issues requiring clinical and policy attention.

Further information can be obtained at Brandeis’s Institute for Behavioral Health at the Heller School.

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