Massive numbers of troops have suffered serious physical injuries serving in the open-ended occupations of Iraq and Afghanistan, but a new report provides some of the first insights into just how broad the mental harm of the war has been.

The study, by Veterans for Common Sense, shows that nearly 20% of the soldiers who have served in either Iraq or Afghanistan suffer from mental health conditions. For those unlucky enough to serve in both wars, the number grows considerably, with some 30% of them suffering from PTSD alone.

The group’s executive director said the government expected “50,000 new patients” for the VA in a 2003 report. The group projected that the figure would be over 1 million by the end of 2013.

The enormous ongoing costs of fighting the war cannot be underestimated, of course, but over the long-term it will likely be the costs of treating the casualties, both physical and mental, which will be the most expensive part of the past decade of adventurism.