Traumatic Brain Injury: Care and Treatment of Operation Enduring Freedom and Operation Iraqi Freedom Veterans

Traumatic brain injury TBI, defined in the medical literature as a disruption in brain function that is caused by a head injury, has become known as one of the signature wounds of the wars in Iraq and Afghanistan due to its high occurrence in post-deployment service members and veterans of these wars. As service members return home, many need ongoing care for mild, moderate, or severe TBI. The growing number of TBI patients and the nature of their injuries creates the need for increased treatment capacity for veterans, and raises a number of policy issues that Congress may move to consider. Due to the variable nature of TBI injury and recovery, there is not one standard of care or treatment regimen for TBI patients needs are diverse, depending on the severity of illness and the presence of co-conditions. It has been estimated by a recent RAND study that as many as 20 of Operation Enduring Freedom and Operation Iraqi Freedom OEFOIF veterans experience TBI. The Department of Veterans Affairs VA has screened almost 250,000 OEFOIF veterans entering the Veterans Health Administration VHA system as of January 2009. As service members return home, these numbers will increase. VA provides a wide range of services to address the needs of veterans with TBI, including outreach, education, and benefits enrollment information. The FY2010 VA Budget included assurances that VA is working to fund programs that improve veterans access to mental health services across the country, including those who suffer from TBI as a result of their service in OEFOIF. In responding to this influx of veterans with TBI and other common OEFOIF illnesses, policy makers and others have identified areas of concern, including challenges in screening, diagnosis, treatment, and access to care. This report provides a review of TBI as an illness, its prevalence among veterans, current activity to address the issue in the VA, and current policy issues.