WASHINGTON (AP) — Only about half of the veterans diagnosed with PTSD last year after serving in Iraq and Afghanistan received the recommended therapy despite efforts by the Department of Veterans Affairs to beef up its mental health staffing, the Institute of Medicine said in a report released Friday. 
 
 About 53 percent of the veterans whose primary diagnosis was PTSD got at least eight psychotherapy sessions within a 14-week period in 2013. But that is significantly short of the department's target of 67 percent, according to the report. 
 
 The Institute of Medicine also found issues with the way active members of the military dealing with PTSD are treated. It described the Department of Defense's treatment programs as "ad hoc, incremental, and crisis-driven, with little planning devoted to the development of a long-range approach to obtaining desired outcomes." 
 
 Together, the two departments spent nearly $3.3 billion in 2012 to treat patients with PTSD. And while both are making strides to identify and treat people with PTSD, many obstacles remain before they will have an "integrated and higher-performing" system, the report said. 
 
 One of the biggest problems is a lack of data to measure which treatments patients are receiving and whether the patients are getting better, said the study's chairman, Sandro Galea of the Mailman School of Public Health at Columbia University. 
 
 "Given that the DOD and VA are responsible for serving millions of service members, families, and veterans, we found it surprising that no PTSD outcome measures are used consistently to know if these treatments are working or not," Galea said. "They could be highly effective, but we won't know unless outcomes are tracked and evaluated." 
 
 Galea said tracking does occur with veterans participating in a specific VA program that involves intensive therapy, but that program serves only 1 percent of veterans who have PTSD, and the data suggest the program yields only modest improvement in symptoms. 
 
 The VA has come under fire recently because of the troubles some new patients have had getting access to care. The IOM's study has been taking place for years, however. The first phase of study, released in 2012, recommended that soldiers returning from Iraq and Afghanistan undergo annual screening for PTSD and that federal agencies conduct more research into which treatments were working. 
 
 For active military, the report notes that each service branch has established its own prevention programs, trains its own mental health staff, and has its own programs and services for PTSD treatment. It said the service branch's lacked an overarching authority to enforce policies related to preventing, treating and screening for PTSD. 
 
 The report also said DOD leaders aren't consistently held accountable for implementing policies and programs to manage PTSD effectively. 
 
 The panel pointed out that the VA has at least established minimum care requirements nationally. Still, it's unclear whether staff adheres to the standards. The VA's computer health records system allows clinicians to track what medications the patients are receiving, but it does not allow for more complete tracking of the types of therapy being used. A new template was supposed to be available for clinicians beginning last November but was not operational as of late January, the report said. 
 
 In a statement, VA officials said they were briefed on the findings this week and will address the recommendations, but they did not go into more detail about how they would do so. A formal response to Congress is due Jan. 1, 2015. 
 
 The Defense Department said it's been taking steps to address problems cited in the report. 
 
 "We agree with the IOM that although great strides have been made, critical gaps remain. We are already taking practical steps to address many of these issues," said Lt. Col. Cathy Wilkinson, a Defense Department spokeswoman. 
 
 For example, she said, beginning in September, all services were directed to begin collecting symptom severity and outcome data for PTSD, anxiety, and depression at all points of service using standardized measures. 
 
 The report recommended that the two departments work together to develop and enact a management system that would document a patient's progress over the course of their treatment, regardless of where they get care. 
 
 Among the other findings by the IOM: 
 
 —PTSD has also increased among veterans from long-ago conflicts. In 2013, 62,536 new cases of PTSD were diagnosed in veterans who did not serve in the Iraq and Afghanistan wars. 
 
 —Veterans of the Iraq and Afghanistan wars use the VA at rates double those of other veterans, 54 percent for Iraq and Afghanistan veterans versus 27 percent for all veterans. 
 
 —PTSD is the third most common major service-connected disability after hearing loss and ringing of the ears. 
 
 The Institute of Medicine is an independent group of experts that advises the federal government on medical issues. Its recommendations often make their way into laws drafted by Congress and policies implemented by federal agencies. ||||| Kryn Miner in Afghanistan. Miner, an Army veteran who suffered from post-traumatic stress disorder, was shot to death in Essex, Vt., by one of his children in April after threatening to kill the family. His wife, Amy, says the Veterans Affairs health system must do more to help veterans who struggle with PTSD after returning home. (Photo: 2010 AP photo courtesy of Amy Miner) 
 
 The Pentagon and VA are not ready for a potential flood of war-related post-traumatic stress disorder among troops and veterans, particularly from the Iraq and Afghanistan conflicts, a panel of leading scientists report in a study released Friday. 
 
 "We are at the cusp of a wave of PTSD," says Sandro Galea, a physician, epidemiologist and professor at Columbia University who chaired the committee of 16 experts for the Institute of Medicine, the health arm of the National Academy of Sciences. 
 
 The committee, directed by Congress, spent four years producing a 300-page report on how the Defense Department and the Department of Veterans Affairs handle PTSD. 
 
 "We greatly appreciate and respect the extensive scientific review and insights of the Institute of Medicine committee," says Robert Jesse, the VA acting undersecretary for health. "We will address these recommendations." 
 
 The Pentagon issued a statement acknowledging "critical gaps" and said corrective steps are being taken. 
 
 A key failure cited by the committee is delay in treating those who need therapy, a central element of the current wait-time scandal that led to the May 30 resignation of VA Secretary Eric Shinseki. 
 
 The scientists cite data showing dramatic growth in the mental illness after 13 years of war, with numbers of soldiers and Marines who returned from war with PTSD increasing tenfold between 2004 and 2012. 
 
 Slightly fewer than 200,000 Iraq and Afghanistan veterans were found to have service-connected PTSD in 2003. By last year, that number had surpassed 650,000, the report says. And many of those veterans were not seeking treatment at the VA. 
 
 There are about 22 million veterans in America, of whom 2.2 million served in Iraq and Afghanistan. 
 
 While applauding some of the initiatives taken by the Defense Department and the VA in dealing with PTSD, the scientists say both agencies show inconsistent and sometimes poor practices in helping patients. 
 
 "We still do not have a PTSD system that is delivering high-quality care for all service members and veterans," Galea says. 
 
 Neither department systematically tracks whether servicemembers or veterans are improving after receiving therapy. In some cases, counseling is delayed, interrupted or cut short. Without data on success or failure rates, improving overall care is not possible, the report says. 
 
 "To deliver high-value health care, an organization must be able to determine patient outcomes," the report says. "However, neither DoD nor VA is in a position to do that." 
 
 Army Lt. Col. Catherine Wilkinson, in a response from the Pentagon, said all service branches were directed last September to begin collecting data on how troops improve while in therapy for PTSD, anxiety and depression. She said the RAND Corp. has been asked to survey military hospitals on the quality of their counseling. 
 
 The science panel, in the report released Friday, noted that great sums of money are being spent. Congress has authorized $900 million for mental health and traumatic brain injury care. The Pentagon expenditures on PTSD grew from $30 million 2004 to nearly $300 million in 2012. The VA spent more $3 billion treating the illness in 2012, including $673 million on Iraq and Afghanistan veterans. 
 
 Much of the money goes to private-sector counselors, because neither agency can handle all their patients, but the qualifications of these contracted therapists are not evaluated, the report says. 
 
 Other problems cited: 
 
 • One-third of VA hospitals and clinics report mental health staffing that is inadequate. Patients wait an average of nearly eight weeks to see a VA counselor for PTSD and 2½ months to get into intensive treatment programs. 
 
 • The percentage of the VA research budget devoted to PTSD has declined in recent years from 32.4% in 2010 to 24.6% in 2013. 
 
 • Communication between VA and Pentagon mental health leaders and clinicians is so poor that it "can lead to duplicative, expensive, ad hoc and perhaps ineffective programs and services while other programs that may be effective languish or disappear." 
 
 • Veterans are not getting a full round of counseling. The VA reported that in 2013, only 53% of Iraq and Afghanistan veterans in therapy received the standard-of-care minimum of eight sessions in 14 weeks. 
 
 Read or Share this story: http://usat.ly/1qmkmQs ||||| The Defense Department and the VA cannot say if their own doctors are successfully treating hundreds of thousands of troops and veterans with PTSD because neither agency is adequately tracking long-term patient outcomes, the Institute of Medicine said Friday. 
 
 Combined, the two departments spend $3.3 billion annually on medications and therapies meant to curb or cure Post Traumatic Stress Disorder. 
 
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 But physicians at the DoD and Veterans Affairs Department also don’t share with one another information on the medical hits or misses they’ve documented from their differing attempts to ease PTSD symptoms, IOM members claim in a new report. 
 
 Those tracking and communications lapses all seem to lead to one question: Do some or most ex-troops with post-combat anxiety eventually get better? 
 
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 “We are hoping this serves as a clarion call and blueprint to guide where we should be,” said Dr. Sandro Galea, chair of the IOM committee that carried out a Congressionally mandated assessment of PTSD programs at the two departments. 
 
 “We found it surprising that no PTSD outcome measures are used consistently to know if these treatments are working or not," added Galea, professor and chair of the department of epidemiology at Columbia University in New York City. "They could be highly effective, but we won't know unless outcomes are tracked and evaluated.” 
 
 The IOM, an independent, nonprofit organization, also urged the two agencies to begin collaborating on the health progress of all current and former military members diagnosed with PTSD –- “regardless of where they receive treatment.” 
 
 In response, the VA’s Acting Under Secretary for Health, Dr. Robert Jesse, said he and his colleagues “appreciate and respect” the IOM’s exhaustive review, adding the agency "will address these recommendations to better serve and meet the expectations of our veterans." 
 
 Defense officials similarly lauded the "thorough assessment," which recognized the resources DoD has devoted to collect symptom severity and PTSD outcome data "at all points of service" by using a series of clinical outcome measures, said Lt. Col. Cathy Wilkinson, a DoD spokesperson for Personnel and Readiness. She added that Defense already "is collaborating" with VA to "identify a common set of outcome measures and quality metrics for monitoring, assessing, and improving the mental health care provided to service members and veterans." 
 
 "We agree with the IOM that although great strides have been made, critical gaps remain," Wilkinson said. "We are already taking practical steps to address many of these issues." 
 
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 During 2012, DoD spent $294 million -– while the VA invested more than $3 billion –- on programs and services “that range in their intensity” to prevent, screen, diagnose, and treat current and ex-service members who have PTSD, or who are at risk for it, the IOM said. 
 
 PTSD is the third most common service-connected disability following hearing loss and tinnitus, or ringing in the ears. During 2012, 13.5 percent of U.S. soldiers had a PTSD diagnosis as well as 10 percent of Marines, 4.5 percent of Navy personnel, and 4.4 percent of Air Force members, the IOM noted. 
 
 The Congressional Research Service says that between 2002 and Jan. 10, 2014, military doctors diagnosed more than 118,000 American troops with PTSD symptoms, which may include nightmares, fears of crowds and driving, feelings of isolation, lack of trust, sleep deprivation and a chronic feeling of hyper-vigilance. 
 
 The IOM also found: 
 
 The Defense Department’s PTSD programs "appear to be local, ad hoc, incremental, and crisis-driven, with little planning devoted to the development of a long-range approach.” 
 
 Leaders within DoD and the service branches “at all levels” are not consistently held accountable for failing to implement programs meant to effectively manage PTSD in troops. 
 
 It’s unclear whether VA hospital administrators around the country follow the agency’s minimum-care requirements for veterans with PTSD. 
 
 Kris Goldsmith, 28, who deployed to Iraq in 2005 as an Army forward observer, says he's received very different treatment at two separate military facilities. 
 
 In February 2007, Goldsmith, then an active-duty soldier, began receiving mental-health attention at an Army base -– Fort Stewart, Georgia -– for what VA physicians later would identity as severe PTSD, he said. 
 
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 “I was treated with a certain level of hostility by the (Army) doctors,” Goldsmith said. “They had explicit instructions to either get troops deployable or get them out of the Army. 
 
 “The DoD system exacerbated my symptoms,” Goldsmith added. “The lack of treatment I was getting there did lead to my eventual suicide attempt.” 
 
 On Memorial Day in 2007, Goldsmith says he ingested a dangerous mix of Vodka and pills. He was found unconscious after a friend noticed he was missing. 
 
 These days, Goldsmith attends college on Long Island, New York. For medical treatment, he goes to the Northport VA Hospital. He calls the care there “fantastic.” Unlike the VA facilities assessed by the IOM, doctors at Northport still track his mental health. 
 
 “The care there doesn’t have anything to do with the VA system as a whole; that has to do with the individual team I happened to be assigned,” Goldsmith said. 
 
 “When I began seeing him, my (VA) doctor, he recognized I was in enough of a crisis that he would skip lunch, and he would stay late so he could treat me. He basically made sure,” Goldsmith said, “that I was safe with myself.”
– The Pentagon and Department of Veterans Affairs are ill-prepared to handle a looming PTSD epidemic—or even the cases they already have, according to a 300-page study released today. Experts from the Institute of Medicine, under direction from Congress, found that just 53% of veterans whose primary diagnosis was PTSD got the recommended eight sessions of psychotherapy over a 14-week stretch last year, well short of the VA's 67% target, the AP reports. The Pentagon isn't doing much better; its programs for treating active-duty PTSD sufferers are "ad hoc, incremental, and crisis-driven, with little planning devoted to the development of a long-range approach," the report concluded. What's more, neither department is effectively measuring whether their PTSD programs—which cost $3.3 billion in 2012—are actually working. "We found it surprising that no PTSD outcome measures are used consistently," one epidemiologist tells NBC News. All of which is troubling, because experts expect the steady stream of diagnoses to continue. "We are at the cusp of a wave of PTSD," the committee's chair tells USA Today.