Mental health evacuations spike in war zones

More than 10 percent of medical evacuations from Iraq and Afghanistan over the past eight years have been for mental health reasons.
From October 2001 to September 2009, 5,480 troops were flown back to the U.S. or to Germany due to “mental disorders,” according to the Armed Forces Health Surveillance Center.
Most of the evacuations were for adjustment reactions or affective psychoses.
But the flow has not been steady over the past eight-plus years. Mental health issues only accounted for 6 percent to 9 percent of the evacuations from 2001 to 2005 — then jumped by 50 percent in just one year, from 714 in 2006 to 1,063 in 2007.
“The sudden increase in evacuations for mental disorders coincided with the surge in U.S. deployed troops and a change in strategy in Iraq,” wrote Timothy Powers, of the center’s Data Analysis Group, in a report about the evacuations. “The increase may reflect cumulative stress among individuals deployed more than once and/or increased awareness and concern regarding psychological stress-related disorders among deployed service members.”
Overall, 52,283 troops have been evacuated from the war zones, with 10,103 — or about 19 percent — going home for battle injuries. The number of battle injuries increased at the start of the war in Iraq — from 970 in 2003 to 2,042 in 2004 — and again during the surge in Iraq — from 1,640 in 2006 to 2,178 in 2007, and then went back down to 983 in 2008. About 4 out of 5 evacuations were due to illnesses or non-combat injuries.
The most common reasons for evacuations were musculoskeletal injuries — mostly back and knee — at 16 percent; non-battle injuries at 15 percent; mental disorders at 10 percent; and “signs, symptoms and ill-defined conditions” at 10 percent.
More than one-quarter of those ill-defined conditions involved “respiratory symptoms.”
Of the two million people who have deployed to Iraq or Afghanistan, 248 were evacuated due to pregnancy, according to the surveillance report. Of those evacuated overall, 45,975 were male and 6,308 were female.
The researchers also found that of those who were evacuated, many had had a medical encounter for the same issue within 90 days of deploying: 29 percent of those with musculoskeletal issues, 23 percent of those with respiratory issues, 22 percent of those with nervous system issues, and 18 percent of those with mental health issues.
“There may be opportunities to refine predeployment medical assessment procedures to reduce recurrences and exacerbations of preexisting conditions, and thereby decrease related medical evacuations among deployed service members,” Powers wrote.