Veterans who suffer from post-traumatic stress disorder (PTSD) have access to the Veterans Health Administration and Defense Department, which acts as a center for research, data, and services for combat-related PTSD treatment.
But for the millions of non-veterans suffering from PTSD, treatment resources are far less comprehensive and accessible, according to a new study published in the Harvard Review of Psychiatry.
“For the other people affected by PTSD — victims of sexual assault, child abuse, and natural disasters — there really isn’t an organized body of research that generates guidance for how they and their caregivers should deal with their PTSD,” said lead author Dr. Judith Bentkover, professor in the Brown University School of Public Health.
“The best PTSD treatment model we have can be found within the VA,” Bentkover said. “Kids have PTSD. Women have PTSD. It’s not just a disease of veterans, although they are a very important and poignant cohort of people who have it. Sexual assault victims, abused children, survivors of natural disasters do not necessarily have a VA to go to. What do they do?”
Bentkover’s interest in PTSD began when she was co-teaching a class on mental health policy with former U.S. Rep. Patrick Kennedy, who was a visiting teaching fellow at Brown. Bentkover found that while many veterans still struggled to receive help for PTSD, non-veterans had an even more challenging time finding the right treatment.
For many non-veterans, Bentkover said, it may be daunting to get connected to care. Even further, untreated PTSD may develop into other medical problems and become more costly and difficult to overcome.
As an economist, she said she recognizes not only that people are suffering but also that they may be considerably less productive during their struggle. Those with untreated PTSD may require public expenditures if they become jobless or homeless. Marital and family discord that results in broken families could impose costs on their children.
“PTSD is not only a huge health care problem, it is a huge cost,” she said.
Bentkover led a team of seven researchers who reviewed the academic and economic research literature on civilian PTSD treatment as well as consumer-oriented websites. While some resources specific to non-veterans could be found, there was too little information geared toward helping non-veterans or their doctors understand, compare, and access treatment they believe would be right for them.
“A major finding of the authors’ search for nonmilitary service providers is that there is no centralized listing of PTSD providers, treatment programs, and support programs at the state or local level and limited listings at the federal level,” the authors wrote.
To some extent the small amount of patient-specific treatment guidance stems from the lack of studies evaluating the effectiveness of PTSD treatment for civilians, the authors said, but also there hasn’t been a coordinated effort to amass what is known.
While many institutions and segments of society, including the U.S. Department of Defense and the VHA, have become more supportive of veterans affected by PTSD in recent years, a robust support network for nonveterans with PTSD does not appear to have emerged, she said.
“We know that gender, race, and culture affect how people deal with anxiety. The research that there is to date doesn’t provide a robust evidence base for treating PTSD in specific vulnerable subpopulations, by either sociodemographic cohort or by cause of PTSD,” said Bentkover.
“And where there are some good studies, we need better ways of organizing, synthesizing, retrieving, and translating the information we do have so that all treatment providers, patients, and caregivers can benefit from this knowledge.”