About a third of U.S. veterans of the war in Iraq access mental health services in the year after returning from war.

So says a study in The Journal of the American Medical Association. The researchers included Charles Hoge, MD, of the Walter Reed Army Institute of Research’s division of psychiatry and neuroscience.

A greater percentage of Iraq war veterans accessed mental health services in the year after their return than those who had served in Afghanistan, Bosnia, and Kosovo, the study shows.

Veterans who had experienced combat or been hospitalized in Iraq were most likely to access mental health services, Hoge’s team found.

Returning From War

Data came from two sources:

--Postdeployment health surveys, which included questions about mental health and were given to all service members within 2 weeks of returning home.

--The Defense Medical Surveillance System, a database of service members’ medical records.

More than 424,000 service members -- mostly from the Army and Marine Corps -- took the postdeployment surveys. The majority had served in Iraq.

The surveys covered general health, depression, posttraumatic syndrome, suicidal thinking, aggression, and interest in receiving mental health services.

The study showed that 19 percent of Iraq war veterans qualified as having a “mental health concern,” compared with 11 percent of veterans who had served in Afghanistan and about 8 percent of those who had been deployed to other locations.

Longer Look

The database provided a lengthier look at veterans’ use of mental health services.

During the first year after returning home, 35 percent of Iraq war veterans accessed mental health services and 12 percent were diagnosed with a mental health problem.

“It is not clear why there was such a high use of mental health services without a mental illness diagnosis,” write Hoge and colleagues. They call the rate “markedly higher” in Iraq war veterans, compared with veterans who served in Afghanistan and elsewhere, as well as rates in service members before deployment.

Two-thirds of service members who accessed mental health services did so within two months of returning home, the study also shows. That’s “encouraging,” write the researchers, because identifying problems early is the first step to treatment.

However, studies have shown increased rates of mental health problems three to four months after deployment, suggesting that there may still be “considerable barriers to care,” Hoge’s team writes.

By Miranda Hitti, reviewed by Louise Chang, MD

SOURCES: Hoge, C. The Journal of the American Medical Association, March 1, 2006; vol 295: pp 1023-1032. News release, JAMA/Archives.