Publication year
2017
Citation Title
Mental health treatment utilization in OIF/OEF National Guard and Reserve troops with and without DSM diagnoses.
Journal Name
American Journal of Orthopsychiatry
Journal Volume
87
Issue Number
2
Page Numbers
157-165
DOI
10.1037/ort0000226
Summary
Data from a recently deployed National Guard and Reserve sample were used to assess the prevalence of mental health issues and mental health service utilization within 12 months post-deployment. The associations between mental health diagnosis, distress, functioning, and social support on mental health care utilization were examined. Results indicate that mental health diagnosis, distress, and functioning, but not social support influenced Service members mental health service utilization.
Key Findings
Only 50% of National Guard and Reserve members determined to have a potential need for mental health services received treatment.
Service members diagnosed with depression or anxiety disorders were the most likely to seek treatment while those diagnosed with posttraumatic stress disorder (PTSD) were the least likely to seek treatment.
Higher levels of distress and lower levels of functioning were associated with more treatment utilization.
Thirty-six percent of participants had contact with at least one mental health provider within 12-months post-deployment; the majority of those Service members sought individual therapy.
Implications for Program Leaders
Continue to offer support and services to military families with a Service member returning from deployment with mental health diagnoses
Provide education to Service members and their families regarding the resources available for Service members returning from deployment
Continue to train professionals who work with military families to recognize mental health issues among recently deployed Service members
Implications for Policy Makers
Continue to support programs and services that work with military Service members and their families during the reintegration phase of the deployment cycle
Continue to support military campaigns that aim to reduce the stigma associated with utilizing mental health services for Service members
Recommend education for service providers regarding the possible effects of deployment on Service members and their families
Methods
Participants were recruited as part of a larger study examining the risk factors associated with PTSD after deployment.
Only participants who provided data for at least 12 months post-deployment were included in this study.
The following criteria was used to determine potential need for mental health services: (1) at least one Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DMS-IV) diagnosis; (2) a Global Assessment of Functioning (GAF) score less than 61 (ranges from 0-100, with higher scores indicating better functioning); and (3) a distress severity score of 0.61 or higher (range not given).
Participants
Participants included 169 National Guard and Reserve members who recently returned from deployment and who had completed at least 12 months post-deployment follow-up.
The majority of participants were White (88%), male (95%), and the average age was 34.8 years.
Thirty percent of the sample met criteria for at least one DSM-IV diagnosis; depression was the most common mental health diagnosis (26%), followed by alcohol dependence (20%), PTSD (13%), and drug dependence (9%).
Limitations
The sample consisted of National Guard and Reserve members, therefore results may not generalize to other service branches.
The majority of the sample were male, therefore results may not generalize to female National Guard and Reserve members.
Only formal treatment approaches were examined, therefore results may not accurately reflect treatment utilization of Service members who sought treatment through more informal routes (e.g., religious leaders).
Avenues for Future Research
Continue to examine which mental health and demographic factors influence mental health service utilization for military Service members returning from deployment
Examine which barriers to care are most influential in deterring military Service members who are in need mental health care from accessing it
Examine to what extent Service members utilize less formal treatment approaches to cope with mental health issues
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
Military service members have an increased risk of developing mental health (MH) problems following deployment to Iraq or Afghanistan, yet only a small percentage seek mental health treatment. The aim of the present study was to explore patterns of MH service utilization within the first 12 months following return from combat deployment. Participants were 169 service members who had returned from war-zone deployment in either Iraq or Afghanistan and had assessments covering a 12-month period following their homecoming. The authors first examined the prevalence of mental health diagnoses and engagement with mental health treatment (e.g., visits to the emergency room, inpatient hospitalization, individual therapy, group therapy, family or couple therapy, medication appointments, and self-help). Regression analyses explored whether distress, functioning, diagnoses, or social support predicted treatment use. Findings indicated that 28 of 50 military service members (56%) who met diagnostic criteria for a mental health disorder accessed services in the year following their return from deployment. Individual treatment was the most common modality, and those with major depressive disorder (MDD) reported the most treatment contacts. Social support was not associated with use of mental health services. Baseline functioning and psychiatric distress predicted entry into treatment whereas only psychiatric distress predicted amount of mental health service use in the 12-month postdeployment period. Findings highlight the need for enhanced strategies to link those reporting psychiatric distress with MH treatment services and increase community connectedness regardless of whether they meet full criteria for a mental health diagnosis.
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