Longitudinal Assessment of Mental Health Problems Among Active and Reserve

OUR PREVIOUS ARTICLE 1 DEscribed the Department of Defense’s (DoD’s) screening efforts to identify mental health concerns among soldiers and Marines as they return from Iraq and Afghanistan using the Post-Deployment Health Assessment (PDHA). However, the article also raised concerns that mental health problems might be missed because of the early timing of this screening. It cited preliminary data showing that soldiers were more likely to indicate mental health distress several months after return than upon their immediate return. Based on these preliminary data, the DoD initiated a second screening similar to the first, to occur 3 to 6 months after return from deployment. This report reviews the mental health responses of the first cohort of soldiers to complete both the PDHA and the new Post-Deployment Health ReAssessment (PDHRA) after return from the Iraq war. Because of the longitudinal focus of the study, we included soldiers only from the Iraq war (not from Afghanistan), the larger cohort with the most consistently high rates of combat exposure. We addressed several questions regarding the 2 screening programs: (1) Overall, what percentage of veteran soldiers of the Iraq war were identified as having clinically significant mental health problems and are rates higher on the PDHRA than on the PDHA? (2) As the UK experience sugAuthor Affiliations are listed at the end of this article. Corresponding Author: Charles S. Milliken, MD, Division of Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD 20910 (charles.milliken@us .army.mil). Context To promote early identification of mental health problems among combat veterans, the Department of Defense initiated population-wide screening at 2 time points, immediately on return from deployment and 3 to 6 months later. A previous article focusing only on the initial screening is likely to have underestimated the mental health burden.