The statement of task for this study evolved out of discussions among 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 for members and former members of the armed forces who were deployed to OEF or OIF and their families as a result of such deployment.

The committee would also determine how it would approach phase 2 of the study, which is meant to be a comprehensive assessment of the physical, mental, social, and economic effects and to identify gaps in care for members and former members of the armed forces who were deployed to OIF or OEF, their families, and their communities.

IOM appointed a committee of 16 experts to carry out this study. The committee members have expertise in sociology, psychiatry, rehabilitation, neurology, economics, epidemiology, survey research, and health policy and management. The Committee on Readjustment Needs of Military Personnel, Veterans, and Their Families decided, at its first meeting, that its approach to gathering information would include consideration of data in the peer-reviewed literature; gathering of data directly from DOD and VA; review of government articles, reports, and testimony presented before Congress; and review of recent IOM reports on PTSD, TBI, and physiologic, psychologic, and psychosocial effects of deployment-related stress. The committee would also seek input from the affected groups and communities.

The committee conducted extensive searches of the peer-reviewed literature in its attempts to understand readjustment needs, and it considered about 1,000 articles that were identified through those searches. Many of the articles, however, focused on outcomes primarily of service in the Vietnam War rather than OEF and OIF. There was a paucity of information in the literature about the current wars; thus, the articles reviewed, although instructive about the numerous outcomes and long-term effects of deployment and redeployment, were in effect a substitute for the information that the committee would like to have had. The committee also requested data from DOD and VA.

The committee examined the basic demographic data on the active-duty forces, the reserve components of the military, and the National Guard that DOD and VA provided, such as number of troops deployed and redeployed, dwell time, marital status, numbers of women deployed, types of injuries reported, and health-care use by OEF and OIF veterans. DOD data were provided by the Defense Manpower Center and the Armed Forces Health Surveillance Center. Committee members reviewed numerous reports that informed it about DOD and VA programs developed for those who have served in OEF and OIF and the costs of such programs. They reviewed reports from the Government Accountability Office, the Congressional Budget Office, and the Congressional Research Service; inspector general reports for VA and DOD; and congressional testimony relevant to the committee’s task. And they reviewed several IOM reports on PTSD diagnosis, PTSD treatment, the effects of deployment-related stress, and long-term outcomes related to TBI.