{"id":93897,"date":"2015-11-11T05:08:40","date_gmt":"2015-11-11T05:08:40","guid":{"rendered":"https:\/\/one.sightlinemg.com\/militarytimes\/uncategorized\/2015\/11\/11\/commentary-pts-and-tbi-treatment-require-public-private-teamwork\/"},"modified":"2026-08-08T09:34:05","modified_gmt":"2026-08-08T09:34:05","slug":"commentary-pts-and-tbi-treatment-require-public-private-teamwork","status":"publish","type":"post","link":"https:\/\/one.sightlinemg.com\/militarytimes\/management\/pay-benefits\/military-benefits\/health-care\/2015\/11\/11\/commentary-pts-and-tbi-treatment-require-public-private-teamwork\/","title":{"rendered":"Commentary: PTS and TBI treatment require public-private teamwork"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">As election year rhetoric begins to kick into high gear, much will be said about our veterans and the issues affecting them. All sides of the political landscape almost assuredly can agree on this: We owe our veterans so much more than acknowledgements on Veterans\u00a0Day. In addition to high-quality medical care, we owe them optimal mental health services to help recover from the &#8220;invisible wounds of war.&#8221;<\/p>\n\n\n\n<p>Years of military conflict have taken an emotional toll on U.S. troops. Approximately one in five of the 2.6 million veterans of the wars in Iraq and Afghanistan suffer from post-traumatic stress and\/or traumatic brain injury. Every day, approximately 22\u00a0<span class=\"rte rte-comment\">twenty-two <\/span>veterans of all wars take their own lives. That\u2019s over 8,000 veteran suicides each year. That is unacceptable and it must change.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The neurological and mental health needs of returning veterans are vast, complicated\u00a0and challenging. Many experience multiple emotional and physiological effects resulting from TBI and PTS, including depression, anxiety, alcohol abuse and drug addiction. Unfortunately, there is not a valid diagnostic test that can independently confirm a diagnosis of PTS and TBI and its severity. As a result, clinicians are forced to rely heavily on what a patient is sharing about his or her condition and symptoms, often leading to severe under-reporting.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It is imperative to learn from the mistakes we made with our returning Vietnam veterans. The recently completed National Vietnam Veterans Longitudinal Study, funded by the Veterans Affairs Department, found that 40 years after the war ended an important minority of Vietnam War veterans continue to suffer from PTS, depression and an increased burden of general medical problems. This study sheds important light on what the road ahead could look like for our veterans returning from the Iraq and Afghanistan wars. A significant number are at risk for poor physical and mental health for a lifetime unless we do something radically different.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">While the magnitude of the problems associated with TBI and PTS in veterans is alarming, addressing their needs is complicated. For example, many veterans do not seek VA or non-VA mental health care either because of stigma, fear of it affecting their military career and benefits, and\/or difficulty accessing high-quality care where they live and work. For those who do seek care, the VA health care system, regrettably, continues to struggle to handle the onslaught of cases.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In order to fundamentally address PTS and TBI in returning veterans, two things are needed: First, funding for community-based care that provides ongoing clinical, emotional and psychosocial support to veterans and families \u2014 without barriers. Second, more research into the biological and psychological mechanisms of PTS and TBI. On the latter, advances are starting to happen.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In one of the largest studies of its kind, researchers at NYU Langone Medical Center, Emory University School of Medicine, Stanford University School of Medicine, SRI International and Fort Detrick in Maryland\u00a0are working together to look into specific biological markers for PTS and TBI that have the potential to transform the way mental health disorders are diagnosed and treated.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This five-year, multimillion-dollar study, supported under a unique public and private partnership led by the Defense Department, the Steven and Alexandra Cohen Foundation and other federal and private funding, is evaluating close to 4,000 Iraq and Afghanistan war veterans in order to develop a panel of biomarkers to objectively classify an individual as having PTS and\/or TBI and advance treatments tailored to the individual. These researchers are using brain imaging, genetic, metabolic and other blood tests, eye tracking and voice biomarkers to determine the variations among veterans with and without PTS and TBI.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A component of this large-scale study, conducted in cooperation with Fort Campbell in Kentucky, is looking at 1,800 active-duty soldiers to assess changes in biomarkers as a result of war and deployment. All of this research will advance diagnostic test development and shed light on the neurobiological and psychological factors underlying resilience to PTS and TBI.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">We have a national responsibility to ensure safe passage back into society for the 2.5 million men and women who have volunteered to serve our country. For many of them \u2014 and their families, who have been psychologically deployed with them \u2014 the battle continues at home long after their service ends. They face changing family dynamics, particularly following long and multiple deployments. Daily routines are adjusted while they are away. Children grow and change. Yet, when they return and they and their families need assistance, health insurance plans often fail to cover mental health services for them and their spouses and children.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That is why public-private partnerships are critical to accelerate discovery of objective diagnostic tests and radically improved treatments for PTS and TBI.\u00a0 Only the resources of public-private partnerships can guarantee critically important research funding and unrestricted access to timely, affordable health care for all returning veterans and their families.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Marmar is the Lucius N. Littauer Professor and chairman of the psychiatry department\u00a0at NYU Langone Medical Center and director of its Steven and Alexandra Cohen Veterans Center.\u00a0\u00a0<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A significant number of veterans are at risk for poor physical and mental health unless we commit money and 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