TABLE 1-1 Service Members Deployed by Component as of April 30, 2009

Army Navy Air Force Marine Corps Coast Guard Total
Active component 582,733 320,140 269,220 209,175 3,539 1,384,807
National Guard* 239,336 N/A 65,295 N/A N/A 304,631
Reserves 125,595 33,891 38,056 37,602 228 235,372
Total 947,664 354,031 372,571 246,777 3,767 1,924,810
* Unlike the Army and Air Force, the Navy, Marine Corps, and Coast Guard do not haveNational Guard components.
SOURCE: Adapted from IOM, 2010.

addition to active-duty service members from all the services. Whereas infectious diseases and catastrophic gunshot wounds were the signature injuries of prior conflicts and wars, the hallmarks of the recent conflicts are blast injuries and the psychiatric consequences of exposure to combat, particularly posttraumatic stress disorder (PTSD). Recent estimates of prevalence of PTSD in service members deployed to OEF and OIF are 13% to 20% (Hoge et al., 2004; Seal et al., 2007; Tanielian and Jaycox, 2008; Vasterling et al., 2010).

Of growing concern to both the Department of Defense (DoD) and the Department of Veterans Affairs (VA) is the high prevalence of PTSD in active-duty and veteran populations. As the conflicts in the Middle East scale down and service members return home, the VA and the DoD may expect a commensurate rise in the number of OEF and OIF veterans needing services. To address this concern, the DoD and the VA have allocated substantial funding to foster research, develop programs, and initiate services to combat PTSD. The focus of the DoD is to maintain force readiness; therefore, it has invested heavily in building psychologic resilience, education, health maintenance, screening, and PTSD treatment services and programs. The VA has more than doubled its funding for PTSD research since 2005 (GAO, 2011a), targeting treatment and rehabilitation of veterans. Since FY 2005, the VA has added more than 7,500 full-time mental health staff and has trained, through national training initiatives, more than 3,400 VA clinicians in two evidence-based therapies for the treatment of PTSD—cognitive processing therapy (CPT) and prolonged exposure (PE). In addition, the VA has trained more than 900 DoD mental health providers in CPT and more than 120 in PE. The VA requires that all mental



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