Prior PTSD, Hurricanes and Impact on Veterans' Mental Health Utilization

While the cost of disasters can be calculated for structural damages, the impact on human suffering in vulnerable populations is difficult to document. Preliminary reports suggest that veterans diagnosed with post traumatic stress disorder (PTSD) may in fact be at greater risk for worsening of PTSD symptoms following a natural disaster, change in patterns of general care and psychosocial stressors. Data from The Veterans Health Administration (VHA) SAS Outpatient Medical Datasets was used for a retrospective comparison of health utilization for veterans diagnosed with PTSD (PTSD+) that were in Florida counties directly impacted by hurricanes and compared with cohort veterans in Florida counties that were not in the direct path of the hurricanes. During the 3 year study period, 153,511 Florida veterans accounted for 1,492,057 daily mental health encounters; PTSD+ veterans accounted for 9.9% of the encounters (n=15,331). Veterans with a diagnosis of PTSD prior to the hurricane season, residing in the counties affected by the hurricane paths, demonstrated an immediate 28% increase in utilization following landfall when contrasted with veterans residing in non-hurricane affected counties (+28.0% vs. -6.5%, p<0.001). Additionally, veterans in affected counties were found to utilize more “Group Psychotherapy” treatment sessions overall (30.3% vs. 27.2%, p<0.001). These findings have implications for the service utilization of veterans with PTSD and the provision of mental health services. The effects of future hurricanes or other types of disasters require consideration of specific services as well as targeting of mental health needs in this vulnerable population with preexisting mental health diagnoses.