More than 1,800 Iraq and Afghanistan veterans have been treated for PTSD by the VA and vet centers in Connecticut—a patient count that has climbed 23 percent over the last year.
The data, obtained from the U.S. Department of Veterans Affairs, also shows that the West Haven VA and other New England-region VA facilities had treated close to 9,000 veterans with potential post-traumatic stress disorder through June 30, 2010 – an increase of 1,480 cases over the prior year.
New England, like some other areas of the country, has a heavy reliance on outpatient treatment for veterans with PTSD, with fewer than 10 percent of returning troops with PTSD reported as receiving inpatient VA treatment, the data shows. Nationally, about 8.7 percent of veterans with PTSD have received inpatient care at VA facilities.
In Connecticut, only 94 veterans diagnosed with PTSD had been admitted for inpatient care in the state’s VA system through the third-quarter of the 2010 fiscal year—representing just 5 percent of veterans with PTSD who sought VA care. The lack of inpatient services, which puts a strain on the VA’s outpatient programs, is of concern to state Veterans’ Affairs Commissioner Linda Schwartz.
“We don’t have the beds. There are returning vets who don’t have any support system in the community, who need to be stabilized, and there’s no room for them at the VA,” Schwartz said. She said some veterans with PTSD and other mental-health issues were being referred to facilities such as the Institute of Living, which lack specialized veterans’ health programs.
Dr. Dolores Vojvoda, director of the PTSD/Anxiety Clinic at the West Haven VA, said the clinic has seen a steady stream of new PTSD cases in the last two years, with the numbers climbing each month. The West Haven VA offers group and individual outpatient counseling, as well as medications, for veterans suffering from PTSD, a complex anxiety disorder triggered by exposure to trauma.
“We are getting very stretched,” Dr. Vojvoda said. “We are really trying to think of the most effective ways of treating people, given our resources…Obviously, if the numbers keep increasing as they are, we will need more resources.”
Dr. Vojvoda said that more than 50 percent of the 20 to 40 newly diagnosed veterans who seek treatment for PTSD at the West Haven clinic each month have substance-abuse problems – a trend that has been reported nationally.
“We’re facing a big problem of substance abuse as a co-morbid issue,” she said. “We’re trying to find ways to address this, by developing [specialized] groups that address both PTSD and substance abuse.”
Only veterans who are in acute psychiatric distress are admitted as inpatients at the West Haven facility, Dr. Vojvoda said. The VA’s Newington campus has a three-month residential program for veterans with PTSD; it has 12 beds.
Nationally, more than 171,000 veterans with PTSD have utilized VA facilities—an increase of 28 percent over the prior year. The VA’s count includes only service members who have separated from active duty following deployment.
While the Army’s major bases are located in other parts of the country, the New England VA network, which includes Boston, has seen the ninth-highest number of PTSD cases among the VA’s 23 regional networks, according to VA data.
Topping the list of regions with high PTSD case counts are: Upstate New York, which includes Fort Drum, where 4,381 veterans with PTSD have utilized VA facilities; central Texas, where Fort Hood is located, with 4,813 PTSD cases; Denver, Co., where Fort Carson is located, with 3,568 cases; San Diego, CA, where Camp Pendleton is located, with 3,581 cases; and Puget Sound, WA, where Fort Lewis is located, with 4,318 cases.
In Connecticut, the 1,800 Iraq and Afghanistan veterans with PTSD who have used VA facilities, including vet centers, represent fewer than 15 percent of the more than 12,000 troops from the state who have deployed to war. Veterans’ advocates say stigma and other barriers may be preventing hundreds more veterans from seeking VA care for PTSD.
A survey of Connecticut Iraq and Afghanistan veterans by researchers at Central Connecticut State University, the VA Connecticut Health Care System, and the Yale School of Medicine found that 21.5 percent met criteria for full PTSD, and 22.3 percent for partial PTSD.
Schwartz said those numbers indicate that some veterans with potential PTSD are not seeking care from the VA.
“If you live in New Haven [near the West Haven VA], then the outpatient care is right there,” Schwartz said. “But statewide, if you look at the number of veterans who come to the VA, we’re missing a significant population.”
The number of veterans diagnosed with PTSD is expected to climb in the coming months, after the VA revised its regulations last summer to make it easier for veterans to qualify for benefits. Department rules had required noncombat veterans to document specific traumatic stressors, such as firefights or bomb explosions, that could have caused the disorder. Such documentation was often time-consuming and difficult, or even impossible.
The VA now has reduced the evidence needed for trauma claims that are related to fear of hostile activity and that are consistent with a veteran’s service record. No VA benefits are approved unless a psychiatrist or psychologist confirms a diagnosis of PTSD.
Lisa Chedekel can be reached at chedekel AT c-hit.org