Senate. The secretaries of DOD and VA responded to the Phase 1 report in September 2010. The present report fulfills the requirement for Phase 2.


IOM appointed a committee of 29 experts to carry out the Phase 2 study. The committee approached its task by identifying and reviewing data in the peer-reviewed literature; reviewing government reports and testimony before Congress; reviewing recent IOM reports on posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), and physiologic, psychologic, and psychosocial effects of deployment-related stress; obtaining information directly from DOD and VA; and inviting DOD and VA researchers and officials to present data. The committee also sought input from community leaders to determine effects at the community level; it conducted data analyses and examined data in administrative datasets. Those data-gathering efforts provided the committee with a broad overview of possible readjustment needs and possible solutions related to the effects of deployment in OEF and OIF. Chapter 2 describes in detail the committee’s approach to its task.


The readjustment needs of service members, veterans, and families that have experienced deployment to OEF or OIF encompass a complex set of health, economic, and social issues. Below are the committee’s key findings, which to a large extent are the focus of its recommendations.

• Many veterans return from deployment relatively unscathed by their experience, but others return from deployment with a multitude of complex health outcomes that present life-long challenges and hinder readjustment.

• Not all veterans who need treatment receive it despite the offering of evidence-based treatments by the VA and DOD health systems, because systemwide challenges exist.

• Military families often endure the adverse consequences of deployments, for example, health effects, family violence, and economic burdens.

• Numerous programs exist to respond to the needs of returning OEF and OIF active-duty personnel, veterans, and family members, but there is little evidence regarding their effectiveness.

• Unemployment and underemployment are acute problems for military veterans.

• Published data on the effects of deployment on military communities are sparse.

• DOD, VA, and other federal agencies have data that can answer many of the questions posed in the legislation; however, numerous barriers must be overcome to facilitate sharing and linking of data.

The federal government, in particular DOD and VA, is actively seeking to understand the scope of readjustment challenges, implement appropriate policies, and provide programs and services. In many cases, however, the response does not match the magnitude of the problems, and many readjustment needs are unmet or unknown. The urgency of addressing those issues is heightened by the sheer number of people affected, the rapid drawdown of personnel from Afghanistan and Iraq, and the long-term effects that many of the issues might have not only on

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