Mental and Substance Abuse Disorders And Their Impact On Veterans

Santa Monica Psychiatrist Katherine Watkins, MD, has substantial experience researching mental and substance abuse disorders suffered by veterans. In fact, focusing on the frequency of disorders in relation to vets reveals both good news and situations that can be improved upon. 

Recent research focuses on returning US service members with symptoms indicative of serious mental disorders. It elaborates on the difficulties of providing high-quality treatment to this population. Although returning service members are only 4.1 percent of the total veteran population, their complex psychological needs have made delivering high-quality treatment for mental and substance use disorders a national priority.

“Care For Veterans With Mental And Substance Use Disorders: Good Performance, But Room To Improve On Many Measures” is an in-depth article that covers the subject. It is available on KaterineWatkinsMD.com as a downloadable PDF.

Consequently, in 2006 the Department of Veterans Affairs commissioned the Altarum Institute and the RAND Corporation to do an evaluation of its mental health treatment system. We published the results of our evaluation in the November 2011 issue of Health Affairs, and the findings are as relevant today as they were at the time of the study.

In our evaluation, we found that veterans with mental illness and substance use disorders represented 15.4 percent of all veterans using Veterans’ Health Administration (VHA) services in 2007 and that they accounted for 32.9 percent ($12 billion) of VHA costs, of which the majority was for non–mental health conditions. The average cost for a veteran with mental illness and substance use in our study was $12,337, or 2.7 times the cost for an average veteran without these conditions. The quality of care for the veterans in our study, although similar to or better than the care given to comparable privately insured patients or those enrolled in Medicare or Medicaid, varied by as much as twenty-three percentage points among regional service networks. Performance on some indicators, such as whether those with alcohol dependence received pharmacotherapy, was low. There is a need for substantial improvement in the care of these veterans, particularly with respect to ensuring the delivery of evidence-based treatments.