Post-traumatic stress disorder, substance abuse and other mental illnesses accounted for more days spent by troops in the hospital than any other medical condition in the military in 2012, including war wounds, injuries and illness, according to Pentagon data.
The numbers show how years of exposure to combat trauma created a core of servicemembers with severe mental health problems — about 20,000 last year — who accounted for more lost workdays than those with any other health issue.
In the worst cases, troops remained hospitalized more than a month. Only servicemembers with severe amputations and long rehabilitation stay longer, according to Pentagon data provided in response to USA TODAY queries.
One ray of hope: New Army data show the mental health hospitalization trend that began rising during the depths of two wars in 2006 finally may be reversing.
Days spent in mental health wards are projected to decline 15% in the Army this year, according to Lt. Col. Christopher Ivany, the Army's chief of behavioral health. One key reason, Ivany says, is that military physicians have learned better ways of treating these sick servicemembers through outpatient care.
Military officials blame the wars for the high numbers.
"The increase in mental health hospitalizations is most likely influenced by exposure of servicemembers to stressful events associated with deployment to" Afghanistan and Iraq, says Army Lt. Col. Catherine Wilkinson, a spokeswoman for Pentagon health affairs.
Another problem is stigma, officials say, or the failure by troops to step forward and seek help until their emotional issue becomes so severe that hospitalization is required.
Ivany says enhanced efforts to screen soldiers for mental health problems and make therapists more accessible also have led to greater numbers in treatment. "We are actively trying to find those conditions within our soldiers, all of which drives the increase," Ivany says.
Outpatient therapy sessions in the military for PTSD, substance abuse, marriage counseling or other behavioral issues continue at record levels.
Mental health inpatients made up only 26% of troops hospitalized last year, but they accounted for half of the days troops spent in hospitals. Nearly eight of 10 troops hospitalized for PTSD have been on at least one combat deployment.