By: Justin Curry Ph.D., Lemma Regasa Ph.D., and Joshua Brown B.S.
June 25, 2024
U.S. Air National Guard photo by Master Sgt. Jonathan Young
Psychological health concerns are common occurrences and can have a real effect on how we function. Because these issues have historically been stigmatized, individuals coping with such concerns can feel marginalized. We may worry that the way others perceive us might negatively affect our personal, academic, or professional lives. Sometimes, when we’re dealing with psychological health issues, we can feel isolated and think that there aren’t others out there who understand what we’re going through. Understanding just how common psychological health conditions are can help us feel less alone.
When we want to know more about how common a particular condition is, we often talk about prevalence. Prevalence—often stated as a percentage— is the proportion of a particular group (i.e., active duty service members) experiencing a certain problem over a specific period of time, like within the past year. Figuring out the exact prevalence of a condition in a group can be difficult because it’s hard to know who is and isn’t affected. Because of this, health systems often look at how many people are receiving health care for that condition to make an estimate. However, estimates based on treatment history generally under-count the true prevalence of a condition since they don’t consider people who experience the condition but aren’t engaged in care.
So, just how common are psychological health problems? As part of the U.S. Centers for Disease Control and Prevention, the National Center for Injury Prevention and Control estimates that more than one in five adults in the U.S. are experiencing a psychological health concern at any given time.¹ Addressing the question regarding the number of people who receive psychological health treatment, the Center for Behavioral Health Statistics and Quality estimates that 22.7% of U.S. adults aged 18 or older sought care for a psychological health issue in 2022.² Finally, the National Center for Health Statistics reports the percentage of U.S. adults between the ages of 18 and 44 (a group that more closely matches the active duty service member population) seeking psychological health care services increased from 18.5% in 2019 to 23.2% in 2021.³
Agencies like the CDC estimate the prevalence of psychological health concerns for all the people in the U.S. The Department of Defense can’t just rely on CDC estimates, though, because the demographic characteristics (like gender, age, and race/ethnicity) of the DOD population don’t match those of the larger U.S. population. For example, people over 65 make up a greater proportion of the general population than they do of the Armed Forces. Moreover, many active duty service members face experiences such as deployments, combat exposure, high operations tempo, and rigorous training regimens that may increase their level of risk for psychological health problems above that of the general population. Because of these differences, the Defense Health Agency’s Psychological Health Center of Excellence provides prevalence estimates for the active duty force. By tracking trends in the prevalence of psychological health problems over time, the DOD is better positioned to develop effective prevention and treatment programs.
Psychological health conditions among military personnel can range from more acute concerns, like adjustment disorders, to conditions that may impact us for longer, like post-traumatic stress disorder, depression, or anxiety. Using administrative data from the electronic health record and claims data from TRICARE, PHCoE reports prevalence estimates for various psychological health conditions from 2005 through 2022. During 2022, 17.6% of active duty service members had some form of psychological health concern for which they sought treatment (See Figure 1; F-Series (MH)). This is somewhat lower than the Center for Behavioral Health Statistics and Quality estimates (22.7%) for adults over the age of 17 years in the general population. But we can’t make a direct comparison because of the differences in demographic characteristics. Figure 2 shows that in 2022, adjustment disorders were the most prevalent psychological health concern amongst active duty service members.
Fig. 1. Prevalence rates of major psychological health disorders (Adjustment, Anxiety, Depression, PTSD) and all MH conditions with the initial F ICD-10-CM dx codes (F-series MH).
Fig. 2. Prevalence rates of psychological health conditions in 2022 among all service branches.
Interestingly, within the DOD, the prevalence rate for several psychological health issues remained reasonably stable between 2015 and 2021 and then increased in 2022. For example, Figure 1 shows the prevalence of adjustment disorders increased from 6.2% in 2021 to 7.6% in 2022, while the prevalence of anxiety increased from 4.0% to 5.7% during the same period. The prevalence rate for any psychological health concern (Figure 1, F-Series (MH)) increased from 13.9% to 17.6%. The available data doesn’t speak to why this increase occurred in 2022. It may be nothing more than random variance, or it may be the result of one or more factors that are putting more stress on the DOD population. What is clear, however, is that more active duty service members are seeking care for psychological health concerns, and we will work towards implementing evidence-based prevention and treatment strategies to support the psychological health and well-being of our military family.
Additional Resources:
References
- National Center for Injury Prevention and Control. (2024, April). About mental health. U.S. Department of Health and Human Services, Centers for Disease Control. https://www.cdc.gov/mentalhealth/learn/index.htm
- Center for Behavioral Health Statistics and Quality. (2023, November). 2022 national survey on drug use and health detailed tables. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2022-nsduh-detailed-tables
- National Center for Health Statistics. (2022, September). Mental health treatment among adults aged 18–44: United States, 2019–2021. U.S. Department of Health and Human Services, Centers for Disease Control. https://www.cdc.gov/nchs/products/databriefs/db444.htm
Justin Curry, Ph.D. serves as the Chief of the Surveillance Section at the Psychological Health Center of Excellence. He is a clinical psychologist by training and a veteran of the U.S. Army.
Lemma Regasa, Ph.D., and Joshua Brown, B.S., are contracted scientific data analysts at the Psychological Health Center of Excellence. They support the Surveillance Branch, analyzing DOD psychological health data to identify the most vulnerable populations and provides recommendations and interventions.