Military service men and women who have returned home from Iraq and Afghanistan with untreated mental health issues pose a public health threat, the Centers for Disease Control (CDC) said Sept. 21.

“This is a huge public health problem,” Dr. Marc Safran, chairman of the CDC Mental Health Work Group, said during a CDC Clinical Outreach and Community Activity teleconference. “It must be addressed.”

Entitled “Impact of Deployment on the Health of Service Members and their Families—What Clinicians Should Ask,” the teleconference featured presentations by mental health experts on the importance of mental health screening of military service personnel and their family members.

According to Dr. David S. Riggs, executive director of the Center for Deployment Psychology, mental health issues of military service personnel have impacted 10 million family members since the start of the wars in Iraq and Afghanistan.

Riggs said post-traumatic stress disorder and traumatic brain injury are the two signature psychological wounds of the two wars. Suicides and the attempted suicides by returning veterans have raised concerns about depression as well.

The psychological toll of the deployment of more than two million service personnel—many of whom face prolonged exposure to combat stress over multiple deployments—are disproportionately high compared with the physical injuries of combat, Riggs said.

Family members of military personnel also experience problems with high rates of stress, said Dr. Vikas Kapil, associated director of science for the CDC’s Division of Injury Response.

Kapil said children experience the stress of separation when a family member is deployed, which can impact school performance, cause them to challenge authority and create physical health problems such as high blood pressure. Some children turn to drug and alcohol abuse and face dangers of parental neglect.

Military families face barriers to getting mental and physical medical assistance as most primary care providers are not trained to treat mental issues faced by military service men and women. They may also choose not to seek treatment for fear of being stigmatized.

Dr. Ruth Perou, a child development leader with the CDC, primary care providers should ask patients if they served or are part of a military family, to help better identify potential issues.