A new report required by Congress recommends that the Defense Department assess how well commanding officers handle sexual assault and harassment complaints when reviewing their job performance.
The Institute of Medicine said in the report released Tuesday that military sexual assault appears to be an important factor in the development of post-traumatic stress disorder. It cited previous research indicating that female veterans with a reported history of military sexual trauma were nine times more likely to have PTSD compared with other female veterans.
"Increased efforts by DOD are necessary, and a zero-tolerance approach should be implemented," said the Institute of Medicine, an independent agency that provides advice concerning health and science to policymakers in the federal government and private sector.
The recommendation about sexual assaults was part of a broad look at the health needs of troops and veterans involved in the wars in Iraq and Afghanistan. Although most of the returning troops have adjusted well to life after deployment, 44 percent have reported some readjustment problems.
The most common overlapping health problems are PTSD, substance abuse, depression and symptoms attributed to traumatic brain injuries.
But the problems seen today are really just the beginning, the report said.
"Previous wars have demonstrated that veterans' needs peak several decades after their war service," the IOM panel said.
To prepare for those costs, the federal government should undertake long-term cost forecasts like those that Congress requires for Social Security and Medicare, the IOM said. It said those forecasts should be conducted annually and publicly released by the Veterans Affairs Department and confirmed by an independent expert.
The wars in Iraq and Afghanistan resulted in the deployment of about 2.2 million troops as of mid-December, it said. Women have played a central role in the efforts. They make up 14 percent of active-duty troops and nearly 18 percent of National Guard and Reserve personnel. The panel's recommendations often focused on the needs of returning female veterans. It said recent research indicates that female veterans have a higher risk of developing depression than their male counterparts, though they are less likely to commit suicide.
"For more than a decade, female military service members have been subject to repeat deployments, have endured prolonged separation from families, have served side by side with men and have been exposed to harsh wartime conditions, including witnessing death and destruction," the report said.
Pentagon spokeswoman Cynthia Smith said the department would consider the study's findings and recommendations, and she stressed that sexual assault was not tolerated at the department.
"We are committed to taking care of our people, and that includes doing everything possible to develop the best programs for our service members and their families," Smith said.
The IOM report also said the support services the Defense Department provides to military families tends to focus on married, heterosexual couples and their children. The panel said the military needs to ensure its support services also help single parents, same-sex couples and stepfamilies.
The Defense and Veterans Affairs departments are required to provide Congress with a joint response by June.