Follow-Up Exams Uncover More Iraq Vets With Emotional Woes

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Among all the soldiers screened, 20.3 percent of active duty personnel were referred for mental health care, as were 42.4 percent of reserve soldiers, the study found.

Milliken said he didn't know why the difference exists between the active duty soldiers and the reservists. He speculated, however, that it might have to do with the VA's insurance structure that allows reservists access to free care for service-related health problems.

One expert thinks the new, two-tier system for identifying soldiers with emotional problems is working, but the shear numbers of affected veterans could overburden the VA's health-care system.

"I am not surprised by the rates of PTSD among Iraqi vets," said Dr. Randall Marshall, director of Trauma Studies at the New York State Psychiatric Institute and an associate professor of clinical psychiatry at Columbia University College of Physicians and Surgeons.

Marshall said the difference in PTSD rates among active duty and reserve personnel is expected. "Part of what training is meant to do is desensitize soldiers to all the potential experiences on the battlefield, and the reservists have less training and are therefore more vulnerable to war experiences," he said.

Marshall also said that many reservists have had several tours of duty, "which is something they had not signed up for."

Also, many of these part-time soldiers were split from their units, which means they didn't have as much of a support system as active duty personnel, he said.

Marshall sees another major problem developing for returning veterans. Most psychotherapists aren't trained in the best ways to treat PTSD, he said. "You can't assume because it's a VA hospital everyone there has had this kind of training," he said.

In addition, the number of soldiers needing mental health care is straining an already overburdened system.

"If 20 percent of the veterans realize they need help and start to seek treatment, the system will be overwhelmed. Signs are, it already is," Marshall said.

More information

To learn more, visit the U.S. Department of Veterans Affairs.