Q1. What is Post Deployment Health Assessment?
A1. Post Deployment Health Assessment or PDHA is the military’s
global health screening that occurs when a unit or service member
returns from an overseas deployment.
Q2. What is Post Deployment Health Reassessment?
A2. The PDHRA is a comprehensive health screening that examines for
physical and behavioral health concerns and is conducted 90-180 days
post-deployment. Conducting the PDHRA within this window is critical
as research indicates that this is when symptoms of issues may appear.
It is a required screening for all Service Members and DA Civilians who
deployed outside the continental United States for 30 days or more.
Q3. What is Post Traumatic Stress Disorder, and who
is most susceptible to it? How is it different from routine combat
A3. Post Traumatic Stress Disorder, commonly referred to as
PTSD, is a condition where the war events are re-experienced and
continue to affect a person after they return home. Symptoms of
PTSD include nightmares, flashbacks, feeling revved up or irritable,
feeling numb, and feeling anxious or avoiding any reminders of
war. In contrast, combat stress reactions are short lived reactions
to stress in the combat zone. While the symptoms can be similar,
post-traumatic stress disorder is a longer term condition characterized
by various symptoms that can interfere with social or work functioning.
Q4. How many Soldiers have been referred for mental
health evaluations and how does that compare to diagnosis?
Q4. About a third of all soldiers who return from OIF have received
mental health care in the year after return. This includes screening,
prevention, and treatment services. Most of these Soldiers do
not receive a diagnosis of a mental health problem, and many of
these soldiers were evaluated as response to PDHA screening. Our
data suggest that 10-15% of post OIF soldiers are at risk for
PTSD, meaning they met screening criteria for PTSD. The most common
diagnoses include adjustment reactions, depression, anxiety disorders
and alcohol and substance related problems. Reporting symptoms
does not mean that the Soldier has a psychiatric disorder. More
commonly, Soldiers experience short-lived and normal reactions
that improve over time. However, soldiers may need help if symptoms
persist or interfere with work or social functioning.
Q5. Is seeing a mental health professional a career
killer? Is it confidential?
A5. Seeking medical assistance from a mental health care provider
is not a career ender. The Army is very proactive in encouraging
soldiers to get the help they need, and most Soldiers diagnosed
with PTSD are treated and can remain on active duty. Today, we
have a much better understanding of the psychological effects
of war. Soldiers are being trained to look out for the mental
health of their buddies in the same way that they look out for
their physical health, and leaders are being trained to encourage
soldiers to get help. The message is getting out that coming in
to get help early is the best way to avoid long term problems.
Our intention is to return Soldiers back to duty. Reference confidentiality,
medical professionals keep everything as discreet as possible.
However, there may be times when a command needs to be advised
about a Soldier’s medical care. This usually occurs when
a Soldier is suicidal or homicidal.
Q6. What is the importance of Mental Health Advisory
Teams I and II?
A6. They’re groundbreaking really. These teams deployed
to Iraq to assess how troops were doing on the ground and how
well behavioral health services were working in theatre. Extensive
reports were produced that led directly to changes in the way
services are delivered in the combat zone. The importance of MHATs
is that this is the first time we’ve sent researchers into
a combat zone and that we used the findings to make changes in
the way we deliver care to the theater. For example, MHAT I found
patients found it difficult to get to practitioners. We further
disbursed our practitioners to help Soldiers so that they would
not have to travel as often or as far for care.
Q7. Are some Soldiers more susceptible to mental health
disorders than others?
A7. There are many things that can contribute to susceptibility,
including genetic history (whether there is a family history of
mental health or substance abuse problems) and prior trauma. In
general, those with prior psychiatric history may be more susceptible
to deployment related mental health diagnosis. Data shows exposure
to combat/firefights may be more associated with PTSD symptoms.
MHAT II data showed that women are at about equal risk for mental
health diagnosis as their male counterparts.
Q8. What kind of mental health difficulties might a
service member experience after returning from OIF or OEF deployments?
A8. Reconnecting with families, nightmares, alcohol and/or substance
abuse, aggression, hyper vigilance.
Q9. How can a service member tell if he or she should
seek medical or professional mental health care? And, when is
it better to see a chaplain vs. a social worker vs. a psychologist
vs. a psychiatrist?
A9. If symptoms are interfering with functioning in some way
or if symptoms are leading to dangerous behaviors or thoughts
then they should seek help. It really doesn’t matter a lot
who they see first. Chaplains are often the best first line person
to go to because most battalions have chaplains know the soldiers
and units well. Social workers are more often involved in partner
relation and family problems.
Q10. Typically, what occurs when a Soldier seeks mental health
care in the military medical system?
A10. similar to civilian practice settings; they can receive
individual or group counseling. Medications may be prescribed.
Q11. Are most mental health issues that result from deployments
treatable or curable?
A11. Mental health issues resulting from deployment are treatable
and usually curable. We use a combination of psychotherapy and
medication, as appropriate.
Q12. How are alcohol abuse and other reckless behaviors such
as driving fast or drinking and driving associated with mental
healthespecially following deployments?
A12. Soldiers may use alcohol frequently to calm down. Soldiers
with PTSD symptoms may use alcohol to try to alleviate other symptoms.
However, it only makes things worse. Driving fast is an indicator
of being revved up.
Q13. What should a member of the Reserve Component, who is
no longer on active duty do if he/she experiences mental health
difficulties that require medical expertise? What about their
A13. There are numerous opportunities for Reserve and National
Guard Soldiers to receive immediate attention. They can contact
Military One Source; Family Wellness or Family Support Program,
Chaplains, unit command channel, medical channels, and the VA
can also provide immediate attention or assist with access to
care. The PDHRA provides a more formal review as well as access
to carethis is available or active and separated Reservists.