It is well understood that medical issues like hypertension, diabetes and heart disease cost society billions of dollars each year. Rising medical costs associated with expensive interventions and pharmaceuticals, missed work because of illness, and extended periods of disability are just a few of the more significant culprits. The same is true for psychiatric illness. Depression is one the leading causes of disability and contributes to billions in lost productivity and healthcare costs each year.
The prevention of medical and psychiatric illnesses is a common sense means for reducing the financial burden to society regarding disease and disability. We know that preventing or delaying metabolic related diseases improves quality of life while reducing the financial strain on individuals, organizations and society at large. However, although we assume prevention of common psychiatric disorders like posttraumatic stress disorder and depression would do the same, the data for psychiatric illness in this area are less available. We have even less information in this area with regard to costs associated with PTSD and depression in our veterans.
Researchers from the Naval Center for Combat & Operational Stress Control, Bureau of Medicine and Surgery and the Fielding School of Public Health, University of California Los Angeles, have shed critical light on this important subject. Recently, the journal Military Medicine published their study titled “Preventing PTSD and Depression and Reducing Health Care Costs in the Military: A Call for Building Resilience Among Service Members.” This is what they did, what they found, and what it means.
What They Did
Over a four-year period the researchers utilized a retrospective cohort of active duty service members who were seeking behavioral health care. The cohort participants were connected to one of two military treatment facilities on the West Coast. Patient/self-reported instruments were completed approximately every 10 weeks as part of a different program. Levels of resilience were obtained using the Responses to Stressful Experiences Scale. Primary outcomes assessed included presence and degree of PTSD symptoms and depression.
Secondary outcomes included histories of serious physical illness, mental health treatment, learning disability, psychiatric hospitalization, substance use treatment and a variety of other work and health outcomes. Calculations were then completed and an estimate of savings for the Department of Defense was derived based on the notion that prevention of PTSD and depression through higher level of resilience reduced costs.
What They Found
Service members were more likely to suffer from mental, behavioral and physical ailments if they scored lower with regard to resilience. Notable examples included depression, stress and sleep disturbances. Strikingly, by increasing resilience by 20% it was estimated to reduce PTSD by 73%, depression by 54% and combined PTSD and depression by 93%. It was also estimated that these reductions would save annual costs of $196 million for PTSD, $288 million for depression, and $597 million when both existed.
What Does it Mean?
The military and veteran healthcare systems are large and generally effective systems. However, the number of service members and veterans requiring care places a strain on both. If these researchers are correct, by relying on techniques that can enhance resilience, both systems could see a decline in the number of individuals who need services and consequently reduce their operating costs. The benefits would be seen for the individual as well as society.
Points to Remember
■ Mental health conditions cause significant financial burden for society.
■ Resilience building tactics may prevent the development of common disorders among military personnel to include PTSD and depression.
■ Keeping psychiatric conditions from manifesting can save millions if not billions in savings for the veteran and military health care systems.
Vyas, K. J., Fesperman, S. F., Nebeker, B. J., Gerard, S. K., Boyd, N. D., Delaney, E. M., Webb-Murphy, J. A., & Johnston, S. L. (2016). Preventing PTSD and Depression and Reducing Health Care Costs in the Military: A Call for Building Resilience Among Service Members. Military Medicine, 181, 1240-1247.