Bringing the war back home: XXXX among 103,788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs facilities.

@entity23806 @entity1032 @entity1005 @entity146
BACKGROUND: Veterans of Operations Enduring Freedom and Iraqi Freedom ( @entity23806 ) have endured high combat stress and are eligible for 2 years of free military service-related health care through the Department of Veterans Affairs (VA) health care system, yet little is known about the burden and clinical circumstances of mental health diagnoses among @entity23806 veterans seen at VA facilities. METHODS: US veterans separated from @entity23806 military service and first seen at VA health care facilities between September 30, 2001 (US invasion of Afghanistan), and September 30, 2005, were included. Mental health diagnoses and psychosocial problems were assessed using International Classification of Diseases, Ninth Revision, Clinical Modification codes. The prevalence and clinical circumstances of and subgroups at greatest risk for @entity146 are described herein. RESULTS: Of 103 788 @entity23806 veterans seen at VA health care facilities, 25 658 (25%) received mental health diagnosis(es); 56% of whom had 2 or more distinct mental health diagnoses. Overall, 32 010 (31%) received mental health and/or psychosocial diagnoses. Mental health diagnoses were detected soon after the first VA clinic visit (median of 13 days), and most initial mental health diagnoses (60%) were made in nonmental health clinics, mostly primary care settings. The youngest group of @entity23806 veterans (age, 18-24 years) were at greatest risk for receiving mental health or @entity1005 diagnoses compared with veterans 40 years or older. CONCLUSIONS: Co-occurring mental health diagnoses and psychosocial problems were detected early and in primary care medical settings in a substantial proportion of @entity23806 veterans seen at VA facilities. Targeted early detection and intervention beginning in primary care settings are needed to prevent chronic @entity1032 and disability.
