Monday 14 July 2014

The effectiveness of PTSD treatment provided by the Defense Department and VA is unknown

In a report mandated by Congress the US National Academy of Sciences has said  “The U.S. Department of Defense and U.S. Department of Veterans Affairs should track the outcomes of treatment for post-traumatic stress disorder (PTSD) provided to service members and veterans and develop a coordinated and comprehensive strategy to do so,…” and that “Without tracking outcomes, neither DOD nor VA knows whether it is providing effective or adequate PTSD care, for which they spent $294 million and more than $3 billion, respectively, in 2012..”  

The Chair of the committee at the Academy is Sandro Galea, who is professor and chair of the department of epidemiology, at Mailman School of Public Health, Columbia University, New York City.  

He says that “given that the DOD and VA are responsible for serving millions of service members, families, and veterans, it is surprising that no PTSD outcome measures are used consistently to know if these treatments are working or not.  They could be highly effective, but we won’t know unless outcomes are tracked and evaluated.”

“The report recommends that DOD and VA develop, coordinate, and implement a measurement-based PTSD management system that documents patients’ progress over the course of treatment, regardless of where they receive treatment, and does long-term follow-up using standardized and validated instruments."

The same strange state of affairs also applies in the UK, where large sums of public money are spent with no clear way of knowledge of which approaches or providers produce useful change.
UK charity PTSDResolution has consistently made full, anonymised, data available to any bona-fide researcher on request, as it believes that this vital information should be made available by any therapeutic service to any interested parties, including Veterans, donors, large service charities and the various government institutions that have an interest in the welfare of our Veterans.

PTSD Resolution keeps meticulous records of every client, using standard DoH outcome measures, and can show precisely what has happened to every client in the course of therapy.

Over the last 120 cases for which we have CORE-10 as well as IES-E data over 75% of our cases have experienced ‘reliable improvement’ in clinical terms. We suggest that, as recommended by the report for Congress in the US concludes, it would be in the interests of all concerned to pool data and investigate ways of getting better value for money from the UK spend on treatment for Veterans with mental health problems.

Given appropriate funding PTSD Resolution would wish to conduct follow up research to determine how well veterans cope at a significant period after the last treatment. Organisations wishing to support this work are invited to contact us via the web site. See Key Facts

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