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How much do the US armed forces spend on stress management and resiliency?
Hey there! Thanks for your request on US armed forces spending on stress management and resiliency. In short, the US armed forces spends approximately $792.8 million per year on mental health treatment. This includes programs for resiliency training, PTSD, optimism training, and more. Please find a more detailed breakdown below.
METHODOLOGY
To begin my research, I made the assumption that you were looking for spending on active duty members rather than veterans and refined my search accordingly. This means that I did not include spending by the VA on mental health treatment in the spending estimates I provide.
Much of the statistics provided come from this nextgov article. However, I could only find one of the two Congressional Research Service (CRS) papers mentioned, which largely focused on spending on research rather than the spending on inpatient and outpatient statistics referenced in the nextgov article.
I used this document on the Promotion of Psychological Resilience in the U.S Military to provide a scope of what spending on resilience looks like. Resilience, as per this definition means "strength to endure some type of traumatic stress or adverse circumstances." From this, I made the assumption that stress management falls under resilience training, along with a huge range of mental health treatments such as depression, PTSD, optimism training, substance abuse, and alcohol abuse.
I broke my report up into "Spending Breakdowns and Calculations," "Prevalence of Mental Health Issues," and "Successes and Failures." I included the section on "Prevalence of Mental Health Issues" to give you a scope on how the money may have been spent, though there is little information on exactly which programs get what money other than PTSD and optimism training. In the "Successes and Failures" section I discuss the push back of Resiliency Training by some psychologists and the media.
Please find a deep dive into my findings below.
SPENDING BREAKDOWNS AND CALCULATIONS
- $4 billion on mental health treatment for active duty members over 2007-2012, which comes out to an average of $666 million each year over that period of time.
- Over the same period, about $461 million was spent on mental health care treatment for activated Guard and Reserve members.
- In 2012, when spending on mental health was $1 billion, about $567 million was for outpatient active duty mental health care.
- $287 million was spent over a six year period (2009-2015) on optimism training. Approximately $50 million a year.
$666 million + $76.8 million + $50 million
~ $792.8 million per year
PREVALENCE OF MENTAL HEALTH ISSUES
The CRS reports that "between 2001 and 2011, the rate of mental health diagnoses among active duty service members increased approximately 65 percent." This means that "a total of 936,283 service members, or former service members during their period of service, have been diagnosed with at least one mental disorder." This includes a huge rise in PTSD incidence, as it "soared 650 percent, from about 170 diagnoses per 100,000 person years in 2000 to approximately 1,110 diagnoses per 100,000 person years in 2011." In contrast, alcohol abuse and dependence incidence rates per 100,000 person years fell 20.2 percent and substance abuse and dependence rates increased 28.5 percent.
"The Army, followed by the Marine Corps, has consistently had the highest incidence rates for PTSD, major depression, alcohol dependence, and substance dependence between 2007 and 2010, followed by the Navy and the Air Force," according to the CRS.
Of the average $666 million spent each year (between 2007 and 2012) on mental disorder treatment "approximately 63 percent of mental disorder treatment costs were for outpatient treatment, 31 percent for for inpatient treatment, and 7 percent for pharmacy costs."
Though the Department of Defence (DoD) spent $4 billion on mental health treatment for active duty service members from 2007 through 2012, the CRS report questioned exactly what the Pentagon got for its money. “There are scant data documenting which treatments patients receive or whether those treatments were appropriate and timely,” the report said.
SUCCESSES AND FAILURES
Though this research paper shows a huge improvement in perspective on the significance of mental health treatment for the U.S Military, by highlighting the movement towards placing psychological health on the same plane as physical health, the Resilience Training Program or (Comprehensive Soldier Fitness, CSF for short) has been heavily criticised.
This USA today article provides a scathing review of how poorly soldiers score on optimism indicators, such as "I rarely count on good things happening to me" with 52% of soldiers agreeing despite a 6 years, $287 million optimism program.
This article in Psychology Today states that "the research evaluating the program is of questionable quality and it does not support the strong claims being made about CSF’s effectiveness." This critique is expanded into four main areas of weakness:
1. the researchers’ failure to measure the important outcomes of PTSD, depression, or other psychological disorders despite the availability of validated measures for doing so,
2. a flawed research design that fails to control for important confounding variables,
3. significant problems with the method of data analysis,
4. the researchers’ failure to acknowledge plausible risks of harm from the CSF intervention.
CONCLUSION
The US armed forces spends approximately $792.8 million per year on mental health treatment. This includes programs for resiliency training, PTSD, optimism training, substance abuse, and more. Of the data available, PSTD care seems to get the most funding at approximately $294 million spent per year.
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