Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery
This RAND monograph reports the results of a comprehensive 2007–2008 study of post-deployment health needs among the roughly 1.64 million U.S. troops who served in Iraq and Afghanistan, focused on three "invisible wounds"—PTSD, major depression, and traumatic brain injury—that often go unrecognized despite their effects on mood, thought, and behavior. Drawing on a literature review, a population-based survey of service members and veterans, a review of existing treatment programs, focus groups with troops and spouses, and a microsimulation model of long-term costs, the study finds that evidence-based treatments exist for PTSD and major depression and that delivering them to all affected veterans would pay for itself within two years through gains in productivity and reductions in medical and mortality costs—but only if DoD, the VA, and the broader U.S. health care system make system-level changes to actually deliver that care.