A Navy audit says the Marine Corps’ noncompliance with health surveys could hinder early detection of PTSD

A Navy audit published in October 2018 found that the Corps largely failed to comply with the 90- to 180-day deadline to complete and certify post-deployment health reassessment surveys, or PDHRA.

Specifically, the audit showed that the rate at which the Corps failed to comply with the requirement to complete and certify PDHRAs in the mandated time frame increased from 46 percent in fiscal year 2008 to 64 percent in 2016.

According to the audit, obtained by Marine Corps Times via a Freedom of Information Act request, the Corps has shown a general upward trend in noncompliance with the health reassessment survey.

The post deployment surveys are an important gauge of a Marine’s health that may show signs and early detection of mental and physical health problems, allowing for early treatment.

The Marine Corps contends, however, that while the compliance deadlines are important, the Marine Corps has been focused on completion rates of the survey to ensure all Marines have an opportunity to complete the survey, according to Maj. Craig Thomas, a Marine spokesman.

That completion rate has hovered around 75 percent for the past nine years, Thomas told Marine Corps Times.

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The health reassessment surveys are important because “evidence suggests that Marines may be more likely to develop health conditions and concerns (such as post-traumatic stress disorder) 3 to 6 months after return from deployment,” the audit reads.

The DoD mandated the PDHRA program screens health issues following a deployment with a “specific emphasis on screening for mental health,” the audit reads.

Marines take a variety of health surveys such as a predeployment screening; a post-deployment health assessment, which must be completed within 30 days of returning from deployment; and the PDHRA, which has a 90 to 180-day deadline for completion and certification.

Those three surveys together provide ample evidence of the importance of these screenings for early detection of emerging health issues or post traumatic stress, signs that may not develop till several months after a deployment.

For example, according to the audit, in fiscal year 2017, about 68 percent of Marines who took the PDHA said their health was worse than when they deployed. That number jumped to 77.4 percent following taking the PDHRA.

Moreover, 2.7 percent of Marines in fiscal 2017 said they experienced symptoms of PTSD in the PDHA, that figure jumped to 5.5 percent following the PDHRA.

“The PDHRA provides an opportunity for Marines who have returned from deployment and are experiencing lingering physical, mental, or behavioral health issues to obtain necessary follow-up care/treatment for those issues,” Thomas said.

But meeting the PDHRA compliance deadlines for the Corps is a bit of an administrative strain that requires a partnership between the Corps and Navy medical personnel.

Marines are required to take the surveys, but Navy medical staff must schedule screenings and be on hand to certify the results.

“This means that the PDHRA’s success requires an interdependent relationship between the Marines and Navy Medical,” Thomas said.

The Navy’s 2018 completed audit was a follow-up report to a 2010 audit that made four recommendations to the Corps to strengthen its PDHRA program.

Thomas says the Corps addressed three of the four recommendations but did not implement the fourth, which called for Marines to be notified when they were required to take a PDHRA.

According to Thomas, the fourth recommendation was considered but found to not be “a prudent use of personnel hours or financial resources.”

“Since the Corps had an alternative and productive resolution already in use which accomplished the intent and goal of that particular recommendation, the Naval Audit Service determined that recommendation to be appropriately addressed and closed,” Thomas explained.

The 2018 survey has made three recommendations: train staff to monitor compliance, identify units with the lowest compliance and address the issue, and identify ways to work with deployment health clinics and medical treatment facilities.

Thomas said one of those recommendations was “considered impractical and infeasible due to the limited support personnel available,” but auditors considered the issue appropriately addressed.

The other recommendations are expected to be implemented by Dec. 31, according to Thomas.

“The health of our Marines is imperative for us to remain a ready force and to respond when needed to global events and crises,” Thomas said.

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