New recommendations for PTSD screening and help

A new Congressionally mandated report from the Institute of Medicine says service members and veterans who have post traumatic stress disorder have timely access to evidence-based care.

The Institute of Medicine also recommends that the Department of Defense and the Department of Veterans Affair need to keep more efficient records of the treatments that were given to patients as well as the outcomes of those treatments.

Additional research evaluating the effectiveness of the PTSD programs is also recommended, as well as sharing the outcomes of the results.

PTSD screenings are recommended to be done once a year by a primary care provider that sees patients at the DOD treatment centers or under TRICARE.

“DOD and VA offer many programs for PTSD, but treatment isn’t reaching everyone who needs it, and the departments aren’t tracking which treatments are being used or evaluating how well they work in the long term,” said committee chair Sandro Galea, professor and chair of the department of epidemiology, Mailman School of Public Health, Columbia University, New York City. “In addition, DOD has no information on the effectiveness of its programs to prevent PTSD.”

Many military members do not seek treatment for PTSD because the fear it will affect their military career, they may have to travel a long distance to seek help from a mental health provider, or it may be hard for them to take time off of work to get the treatment are just some of the reasons.

There are also organizational barriers that make the treatment of PTSD difficult at times such as: combat zones, restrictions on when and where medications for PTSD can be used, and logistical difficulties in getting service member and veterans to their appointments.

Joyce Frieden for MedPage Today there are several risk factors for the disorder: experiencing combat, being wounded, witnessing death, serving on graves registration or handling remains, taken captive or tortures, unpredictable and uncontrollable exposure, and sexual harassment or assault.

It is recommended that agencies collect more data on these barriers to better understand them. There also needs to be a support in the research that needs to be done such as telemedicine, which could help improve availability and accessibility.

While the DOD and VA are doing their part in developing a clinical practice guideline for care of PTSD, there is still little information that healthcare providers are adhering to the guidelines. The DOD and VA should help support the research that may help translate the knowledge of PTSD for new approaches for prevention, screening, diagnosis, and treatment.