The La Jolla Veterans Affairs Medical Center, located on the UCSD campus, is gearing up to accommodate Iraq War veterans’ rising demand for health care, especially post-traumatic stress disorder, a mental health issue often linked to exposure to severe emotional distress associated with war.
As war-wounded veterans arrive at the facility, located near Sixth College, diagnosis and treatment of PTSD continues to rise. The disorder’s prominence has sparked significant research collaboration between the VA hospital and UCSD medical centers in the past.
VA Medical Center senior psychologist Jeffrey Matloff said the number of reported PTSD cases is 10 times higher than the preliminary predictions made at the beginning of the war in Iraq, and said that he believes the numbers will continue to grow.
Early in the war, studies predicted that up to 30 percent of Iraq War veterans would develop PTSD.
However, according to Matloff, these numbers may be misleading, since late onset of PTSD may go unreported and even unnoticed for several years after traumatic events.
“”Some veterans will develop chronic PTSD, but many will spontaneously remit without treatment,”” Matloff said.
Feelings of intense fear, hopelessness and horror are the usual indicators of PTSD, which has only been recognized as a psychiatric disorder since 1980. Other symptoms include debilitatingly vivid recollections, recurring dreams, feelings of detachment and withdrawal from society.
The VA hospital’s total patient load has increased 17 percent from 2004 to 2006, and the medical center currently serves the second-largest population of combat veterans in the nation.
According to Michael Kilmer, the hospital’s Operation Iraqi Freedom combat case manager, the center has seen a rise from 427 Iraq War veterans to slightly less than 5,000 in just two years, with approximately 100 more added each month. Many of the veterans have sought treatment for PTSD, and Kilmer said that the hospital has been able to effectively deal with the influx.
“”We are capable of scheduling people within 30 days, which is good compared to a major HMO,”” he said. “”It’s all about providing access to care in a timely fashion.””
In addition to providing care for PTSD, Kilmer said that the hospital will soon hire three new combat case managers to deal with clinical issues, and three transition patient advocates handling administrative issues for Iraq War veterans.
The additions are meant to prevent obstacles caused by bureaucracy and understaffing, and will ensure that VA health professionals are able to work effectively with patients with PTSD and other often difficult-to-diagnose disabilities, Kilmer said.
Modern-day veterans are more comfortable with seeking help for PTSD, Matloff said, and studies have identified effective PTSD treatment procedures and methods of prevention.
He said that earlier cases went largely unreported due to the stigmas surrounding mental health problems, or that many veterans found their own ways, however unhealthy, to cope with the disorder.
Although researchers have discovered methods to help veterans cope, UCSD researchers will continue to collaborate with the VA hospital for future analysis of PTSD, Matloff said.
Currently, all physicians at the VA hospital are affiliated with the UCSD School of Medicine.
New research is in development, he said, and hopes are high that this research will bring improved mental health care for combat veterans.
“”When you can bring out the best from each institution to work on PTSD, the veterans will ultimately benefit,”” Matloff said.
All research conducted on patients at the VA hospital is overseen by the UCSD Institutional Review Board, which approves and audits research, and protects participants’ rights. UCSD and the VA San Diego Healthcare System have enjoyed successful collaboration since the VA hospital opened in 1972.
The VA hospital is one of three congressionally recognized “”Centers of Excellence”” for PTSD and mental health research and treatment, and currently has one of the nation’s largest VA research prgrams, with a budget of nearly $66 million.
