PTSD

While there are dozens of valid uses for VA CareChoice monies, none is more urgent than treating Rural Veterans for PTSD.  People may be both annoyed and inconvenienced if they are not able to get an appointment with an eye doctor, but nobody takes drastic action because of that frustration.  Suicides by Veterans waiting on PTSD appointments happen every day… some accounts show 22 Veterans commit suicide EVERY day, most of the suffering from PTSD, many of them on VA waiting lists.

PTSD treatment at the VA is commonly believed to be about 40% effective – but that does not tell the full story.  Three separate facts give us insight into piecing together the real effective rate of treatment:

  1. The rand Corporation report states greater than 60% of Veterans likely to have PTSD DO NOT EVEN TRY to schedule appointments
  2. Multi-year studies show that of those who DO try to schedule appointments, 50%-54% are successful
  3. The most common form of therapy – Prolonged Exposure, has a 40% success rate (although even that therapy typically sees fairly high rate of Symptom Recurrencewithin 6 months).

When you run these numbers on 500,000 Vets (and average 35% Try, 50% get an appointment) – the results are pretty sobering:

A program that spends hundreds of millions of dollars annually that yields less than a 10% positive outcome needs to be improved.  Rural Health Resources is working in conjunction with a number of legislators, mental health organizations, and state offices to bring a new methodology – SPECIFICALLY tailored to help Rural Veterans – that we believe will:

  1. Be available to anyone with an internet connection
  2. Achieve success rates in excess of 70% (vs. today’s 40%)
  3. Be immediately available to anyone needing help who is VA CareChoice qualified (no travel time necessary)
  4. Treat 50% more Veterans for the same monies being spent on PE Therapy today.
Today the typical course of Therapy takes 12-14 weeks to complete, results in the Vet/Patient having therapy interaction 8 times over that time, and costs – on average – about $6200 (about $8000 for a full year).  RHR’s course of therapy will take 12 weeks, result in the Vet/Patient having therapy interaction 27 times over those 12 weeks, and cost $3995 per patient ($4995 for a full year).

Rural Veterans and Medication

A painful truth is that the majority of the Vets who DO NOT try to schedule an appointment are Rural Vets.  Those Vets are aware of the delays at the VA, and the thought of having to travel 2-5 hours each way to be treated (if they are successful in getting an appointment) makes the thought of getting treatment almost overwhelming.

Because of this the  “Default Option” becomes Medication.  While approximately $500Million per year is spent on PTSD THERAPY, billions of dollars per year are spent on PTSD “treatment”.  The Discrepancy?… those Vets who can’t be treated get medicated.  (there is typically not a qualified Mental Health Therapist within an hour’s drive of a Vet – there is almost always a pharmacy nearby).

A typical one year regimen of Sertraline (the most commonly prescribed Medication – more commonly known as Zoloft) costs about $8000 per year.  In addition many Vets who are PTSD Symptom positive – and who are on Zoloft – find it difficult to work, so they are put on Social Security disability stipends.  A Vet on 50% disability likely gets about $1500 per month, 100% disability is closer to $3000 per month..  So a Vet who is medicated rather than cured costs the system between $26,000 and $44,000 per year.  The VAST majority of those Vets do not WANT to be on Disability, they want to re-enter the workforce. Vets want to avoid the family problems that PTSD invariably creates.

Spending $44,000 per year to “never cure” a Vet with PTSD makes no sense.  

Contact Rural Health Resources to learn more about our plans to change the way that PTSD treatment is done in rural America.