PTSD resources lacking for nonveterans, study finds

Among the sources of PTSD in civilian life are natural disasters, such as tornadoes. New research finds that information and access to care need improvement for nonveterans. / COURTESY MADRICR/WIKIMEDIA COMMONS/BROWN UNIVERSITY
Among the sources of PTSD in civilian life are natural disasters, such as tornadoes. New research finds that information and access to care need improvement for nonveterans. / COURTESY MADRICR/WIKIMEDIA COMMONS/BROWN UNIVERSITY

PROVIDENCE — Post-traumatic stress disorder remains a difficult, urgent and prevalent problem among combat veterans, but millions of nonveterans also experience the condition. A new study in the Harvard Review of Psychiatry finds that, compared to what the Veterans Administration and Defense Department offer, treatment resources for nonveterans are much less cohesive and helpful.
“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 Judith Bentkover, professor of the practice in the Brown University School of Public Health and executive and academic director of the Executive Masters in Healthcare Leadership degree program. “We know that gender, race and culture affect how people deal with anxiety. The [existing] research doesn’t provide a robust evidence base for treating PTSD in specific vulnerable subpopulations, by either socio-demographic cohort or by cause of PTSD. And where there are some good studies, we need better ways of organizing, synthesizing, retrieving and translating the information … so all treatment providers, patients and caregivers can benefit from this knowledge.”
Bentkover became interested in PTSD treatment for veterans when she co-taught a class on mental health policy with former U.S. Rep. Patrick Kennedy, a former visiting teaching fellow at Brown University. She learned that, while many veterans continue to struggle to get help for the difficult but treatable condition, understanding what good care is and accessing such care is even more challenging for some nonveterans.
She added, “The best PTSD treatment model we have can be found within the VA. Kids have PTSD. Women have PTSD. Sexual assault victims, abused children, survivors of natural disasters do not necessarily have a VA to go to. What do they do?”
For many nonveterans, Bentkover said, getting access to care may be daunting. Some people with untreated PTSD may develop other medical problems and tend to account for more health care costs than those who receive PTSD treatment. 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. Untreated individuals may require public expenditures if they become jobless or homeless.
To learn more about available resources, Bentkover led a team of seven researchers who reviewed the academic and economic research on civilian PTSD treatment as well as consumer-oriented websites. While some research and resources specific to nonveterans exists, too little is available to help nonveterans or their doctors understand, compare and access treatment they believe would be right for them.
“Caregiver and patient-centered Internet searches for PTSD treatment programs and support resources located sites that were often rich in information but not necessarily organized to facilitate consumer decision-making,” the authors wrote. “Generally speaking, consumer websites could perform several key functions more effectively, such as simplifying complex evidence regarding treatments, identifying areas of consensus versus controversy and providing concrete tips for navigating among the different treatment options and providers.”
To some extent, the lack of patient-specific treatment guidance stems from a dearth of studies that have evaluated the effectiveness of PTSD treatment delivery among different civilian populations, the authors said, but also there hasn’t been a coordinated effort to amass what is known.
“[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.
The authors’ recommendations for treatment information for nonveterans include:
• Further research on treatment outcomes, access, and costs
• Uniform measures across such studies to ensure comparability and standard means of indexing to improve information discovery
• Pursuing research related to specific causes (such as violent crime) and populations (such as women or children)
• Establishing a patient-centered institute to marshal and maintain resources and best practices for treatment.

In addition to Bentkover, the paper’s other authors are Clayton Aldern, Debra Lerner, Ellen Richardson, Amrita Chadha, Cory Jacques and Sheyda Bautista-Saeyan.
One Mind for Research and the Tug McGraw Foundation supported the study.

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