Barriers to Treatment for Posttraumatic Stress Disorder Among United States Veterans of Operation Enduring Freedom and Operation Iraqi Freedom

Problem Statement

Since October 2001, an estimated 16.6% of the 1.64 million veterans from the wars in Iraq and Afghanistan have returned with Posttraumatic Stress Disorder (PTSD) (Shiner). Despite dramatic increases in the availability and quality of mental health services offered by the Department of Veterans Affairs (VA), only 58% of those 265,600 veterans have sought treatment for their disorder (Shiner). The startling gap between the need and utilization of mental health services for PTSD is unacceptable and must be addressed.

PTSD rates steadily increased in the first three years of the war. The Veterans Health Administration responded to criticism that the increase was the fault of inadequate mental health care. In November 2004 the Mental Health Strategic Plan (MHSP) implemented over 200 new initiatives to transform the system of mental health coverage (Greenberg).

Despite improvements in the availability and quality of mental health services, veterans continue to underutilize treatment due to personal and institutional barriers.

1. Military training, duty and culture promote mental toughness and discourage weakness. This creates stigma around mental health treatment-seeking behavior.
2. Veterans are reluctant to seek care because they worry that documented mental health care on their record will interfere with career advancements.
3. Veterans underestimate the availability and quality of services offered. Many do not understand the improvements made to evidence-based care, and are unaware that the VA has spent $25 million to increase staff and train them in evidence-based care (Beckham).
4. If veterans do choose to report for treatment they lack “readiness for change,” and fear treatment in which they must repeatedly discussing their trauma (Jakupcak).