That finding was included in a scathing report released last week by the Government Accountability Office that said the Department of Defense "cannot reasonably assure that service members who need referrals receive them."
The federal investigative arm of Congress reports that about 5 percent 9,145 of the 178,664 active Army, Air Force, Navy and Marine troops that served in Iraq or Afghanistan between October 2001 and September 2004 were at risk for post-traumatic stress disorder, or PTSD.
Yet just 22 percent of troops who showed an indication on questionnaires that they were at risk for PTSD received a referral for a mental health follow-up.
"It's disgusting," says Georg-Andreas Pogany, who runs Operation JUST ONE, a Colorado Springs mental health initiative that advocates for troops returning from Iraq to get proper access to mental care. "It shows the majority of those who need help aren't getting it when they need it."
PTSD is a severe mental condition that affects soldiers, as well as other individuals who suffer from trauma. The condition can lead to domestic violence, substance abuse and suicide. Treatment, many experts say, can be effective in lowering the incidence of such problems.
The Army has the largest number of troops at risk for PTSD: 7,935 across the nation, according to the report.
Dee McNutt, a spokeswoman for Fort Carson, says approximately 10 percent of the 11,000 soldiers who returned to the base from Iraq in 2005 were referred to a behavioral health specialist after taking the questionnaire. However, the numbers provided by Fort Carson include not just those soldiers at risk of PTSD, but also those showing signs of depression and other health and marital issues.
Most soldiers were referred to a social worker, but about a 275 required an immediate meeting with a psychologist or psychiatrist.
The base relies not just on psychological screenings, but also on the observations of commanders, social workers, chaplains and soldiers, McNutt says.
"Fort Carson and the Army take PTSD very seriously," McNutt says. "Soldiers are educated on the symptoms and where to seek help."
Unnamed Pentagon officials quoted in the report disagreed with the GAO's findings. They highlighted possible reasons why mental health referrals could be low, including "watchful waiting" by military health workers and some health workers possibly considering the questionnaires improper criteria for issuing a referral.
Yet defense officials failed to provide data supporting those theories, the GAO report stated.
The GAO report did not study National Guard and Reserve troops.
Last month, the Independent reported that 46,571 of the troops who fought in Iraq and Afghanistan in the last four years received preliminary diagnoses for a mental disorder. That accounts for 32 percent of the 144,424 veterans to seek health care through Veterans Affairs in that period.
Fourteen percent, or 20,638, of all cases were preliminary PTSD diagnoses.
When troops returned from Iraq and Afghanistan between October 2001 and September 2004, they were asked four questions. A response of "yes" to any three indicates that a soldier or Marine may be grappling with post-traumatic stress disorder and should be referred for further mental evaluation. Here are the questions:
Have you ever had any experience that was so frightening, horrible, or upsetting that, in the past month, you:
Have had any nightmares about it or thought about it when you did not want to?
Tried hard not to think about it or went out of your way to avoid situations that remind you of it?
Were constantly on guard, watchful, or easily startled?
Felt numb or detached from others, activities, or your surroundings?
Source: Government Accountability Office
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