WASHINGTON — The Army could lose a large chunk of its mental health force to furloughs starting next month, limiting access to care for soldiers dealing with post-traumatic stress disorder and other issues.

Although the Surgeon General’s office is looking at ways to exempt some personnel from the sequestration fallout, “right now the plan is that our [Department of the Army] civilians who are employed with us will be impacted across the board,” Col. Rebecca Porter, chief of behavioral health for the surgeon general, told defense reporters Tuesday at a breakfast roundtable.

More than half of the Army’s 4,500 mental health professionals are civilian. Contractors are exempt from furloughs, but those civilians employed directly by the Army are subject to the cuts imposed by sequestration. About 251,000 Army civilians will have to take 22 days of unpaid leave from April 26 to Sept. 30.

“It’s not the quality of the care that we expect to be impacted but the availability and access to it in a timely manner,” Porter said.

That’s something the Army already struggles with. Wait times for mental health providers have been a significant problem at installations across the service, leading the Army to double the number of mental health providers in the last five years – and the service is still understaffed.

The federal government is failing to keep pace with a torrent of ailments and issues generated by two wars for the more than 2 million Americans who served overseas since 9/11, according to a sweeping assessment by a panel of leading scientists.

The nearly 800-page study, completed over four years by the Institute of Medicine and released Tuesday, portrays a nation struggling to anticipate and understand consequences of a decade of war and grueling demands placed on its military and unprecedented kinds of wounds troops have suffered.

The Pentagon and Department of Veterans Affairs are trying to help, but "the response does not match the magnitude of the problems, and many readjustment needs are unmet or unknown," says the report by the institute, the health arm of the National Academy of Sciences.

The nation waged war in Iraq and Afghanistan in unprecedented ways, the study found, using a limited-size, all-volunteer force; deploying troops repeatedly for up to 15 or 18 months at a time; allowing less than a year of rest between tours; and filling the military's ranks with historically high numbers of women, parents, National Guard troops and reservists.

"The urgency of addressing these issues is heightened by the sheer number of people affected, the rapid drawdown of personnel from Afghanistan and Iraq, and the long-term effects that many of the issues might have, not only on military personnel and veterans and their family but on the country as a whole," the study found.

The study was the result of 2008 federal legislation directing the Pentagon to learn more about the readjustment needs of returning troops.

"These are extraordinary challenges," said Dr. George Rutherford, who chaired the group that produced the report. "We are learning as we're going. I think the VA and (Defense Department) have really exerted extraordinary efforts to try and get it right ... but there are some areas that need to be improved."

To this day, almost nothing is known about long-term outcomes of signature, war-related problems such as mild traumatic brain injury, post-traumatic stress disorder, depression and suicidal tendencies, the scientists found.