In response to the growing needs of OEF and OIF active-duty service members, veterans, and families, Congress passed Section 1661 of the National Defense Authorization Act for FY 2008. That section required the secretary of defense, in consultation with the secretary of veterans affairs, to enter into an agreement with the National Academies for a study of the physical and mental health and other readjustment needs of members and former members of the armed forces who were deployed in OIF or OEF and their families as a result of such deployment. The study was assigned to the Institute of Medicine (IOM).

The study consists of two phases. Phase 1 is a preliminary assessment to identify findings on the physical and mental health and other readjustment needs of and on gaps in care for the members, former members, and families described in the legislation and to provide a roadmap for the second phase of the study. Phase 2 is to determine, in detail, the physical and mental health and other readjustment needs of members and former members of the armed forces who were deployed in OEF or OIF and the needs of their families and affected communities as a result of deployment (see Appendix A for the complete legislation). This report fulfills the requirement for phase 1 in the legislation.

The statement of task for this study evolved out of discussions between the Department of Defense (DOD), the Department of Veterans Affairs (VA), and IOM. Specifically, it was determined that in phase 1 the IOM committee would identify preliminary findings regarding the physical and mental health and other readjustment needs of members and former members of the armed forces who were deployed in OEF or OIF and their families.

The committee would also determine the goals of the second phase of the study, which is meant to provide a comprehensive assessment of the physical, mental, social, and economic effects of deployment and to identify gaps in care for members and former members of the armed forces who were deployed in OIF or OEF, their families, and affected communities.

IOM appointed a committee of 16 experts to carry out the study. The committee members have expertise in sociology, psychiatry, rehabilitation, neurology, economics, epidemiology, survey research, and health policy and management. At its first meeting, the committee decided that its approach to gathering information would include considering data from the peer-reviewed literature; gathering data directly from DOD and VA; reviewing government articles, reports, and testimony presented to Congress; reviewing recent IOM reports on PTSD, TBI, and physiologic, psychologic, and psychosocial effects of deployment-related stress; and seeking input from the affected groups and communities. Those data gathering efforts were conducted for the committee to get a broad overview of possible readjustment needs as they relate to the long-lasting impact of deployments to OEF and OIF.

The committee conducted extensive searches of the peer-reviewed literature in its attempts to understand readjustment needs and considered about 1,000 articles that resulted from