Posttraumatic stress disorder (PTSD) is a mental health problem that may develop after an individual experiences or witnesses a life-threatening event. While often associated with war, PTSD may develop after abuse, assault, violence, a terroristic act, or a disaster. The National Center for PTSD estimates that about 12 million adults in the US have PTSD during a given year. A new study finds that the national economic burden of PTSD is $232.2 billion for 2018.

“The $232 billion annual economic burden of PTSD in the U.S. demonstrated in this study is staggering and fuels the urgency for public and private stakeholders to work together to discover new and better treatments, reduce stigma, improve access to existing treatments, and expand evidence-based recovery and rehabilitation programs,” the researchers write.

Dr. Lori Davis, the associate chief of staff for research at the Tuscaloosa Veterans Affairs Medical Center in Alabama, led the study. She and her team used insurance claims data, academic literature, and government publications to estimate the costs of PTSD in both the U.S. civilian and military populations (both active duty and veterans). The data is from the year 2018, the latest year for which data were available. In the study, the investigators identified the extent to which PTSD not only impacts veterans but civilians, as well. The researchers found that civilians accounted for 82% of the total PTSD costs, compared with 18% for the military population. That disparity is predicated on the fact that the number of civilians far exceeds that of active-duty military and veterans. Although PTSD is more prevalent in the military, the number of civilians with PTSD still tops the number of Veterans with that condition. Davis and her colleagues noted that more studies on PTSD and its treatments are needed to address the rise in civilians with PTSD.

The researchers also found that women represented 66% of the overall and 74% of the civilian population with PTSD, thereby contributing disproportionally to the national costs. Research has shown that trauma-exposed women show higher levels of PTSD symptoms than trauma-exposed men. It should be noted that traumas such as sexual assault and domestic violence tend to affect more women than men and represent important areas for prevention and treatment.

Although civilians accounted for more than three times the total PTSD costs, the annual costs per civilian with PTSD ($18,640) were lower than that of the military population ($25,684). In the civilian population, direct health care and unemployment costs accounted for the economic burden, while disability and direct health care costs drove the burden in the military population. Non-direct health costs such as disability payments are higher in military populations, according to Davis.

“With the increasing occurrence of national and societal traumatic events around the world, including COVID-19, civil unrest, and climate change, there is a mounting concern of an increase in PTSD and burden in the civilian population. As such, the current cost estimate is likely an underestimation given these recent global traumas, the effects of which would not have been captured and are likely to result in increasing negative repercussions.”

“It is important to remember that we have effective treatments for PTSD,” says Dr. Paula Schnurr, executive director of VA’s National Center for PTSD. “One potential implication of this study’s findings is that increasing treatment could reduce not only the symptom burden on people but also the economic costs to society as a whole.”

The complete study may be read here.



Photo by Kat Smith.