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Mental Health Leading Cause of Hospitalization in Active Military

Mental health disorders are the leading cause of hospital bed days and the second leading cause of medical encounters among active component service members in the U.S. Military, according to a new study.

Between 2000 and 2012, 159,107 active component service members experienced 192,317 mental disorder hospitalizations, according to the study published in the Medical Surveillance Monthly Report. In 2012, this number declined slightly (n = 21,360).

The overall increase since 2006 was largely due to sharp increases in hospitalizations for PTSD, depression, alcohol abuse/dependence, and adjustment disorder (% increases in hospitalizations, 2006-2012: PTSD: 192%; depression: 66%; alcohol abuse/dependence: 110%; adjustment disorder: 52%)

Similar rates of increase occurred among members of the reserve component. During the same period, 22,456 reserve and guard service members experienced a total of 26,925 mental disorder hospitalizations. The number of mental disorder-related hospitalizations almost doubled from 2002 (n = 961) to 2003 (n = 1,868) and then remained relatively stable though 2006. As in the active component, annual numbers of mental disorder-related hospitalizations after 2006 increased each year through 2011; between 2006 (n = 1,919) and 2011 (n = 3,101), mental disorder-related hospitalizations increased by approximately 62%.

In active component service members, during each year from 2000 to 2003, there were more hospitalizations for adjustment disorders than any other category of mental disorders; however, during each year from 2004 to 2012, there were more hospitalizations for depression than any other category of mental disorders.

In general, greater than 50% of mental disorder-related hospitalizations had a co-occurring mental disorder diagnosis in a secondary diagnostic position in the same hospitalization record. Overall, the percentages of co-occurring mental disorder diagnoses increased between 2000 and 2012 for every category of mental disorder-related hospitalization.

PTSD hospitalizations had the highest percentage of co-occurring mental disorder diagnoses (77.3%); this percentage increased every year between 2006 and 2012 (2006: 70.2%; 2012: 82.5%). Overall, PTSD hospitalizations also had the highest percentage of co-occurring diagnoses related to alcohol or substance abuse or dependence (2000-2012: 27.8%); this proportion increased every year between 2004 (16.3%) and 2010 (30.1%), and then slightly declined (2011: 28.5%; 2012: 29.0%).

Among hospitalizations for each of the six most frequent primary diagnoses of mental disorder, suicidal ideation was listed as one of the top three most frequent co-occurring diagnoses except for hospitalizations for substance abuse and dependence, for which it was listed as the tenth most frequent co-occurring diagnosis.

The increases in mental disorder-related hospitalizations documented in this report are cause for concern for several reasons; among these is the demonstrated association between psychiatric hospitalization and risk of suicide. The association between suicidal ideation and psychiatric hospitalization is well documented.

— Source: Armed Forces Health Surveillance Center