Publication year
2013
Citation Title
Are Iraq and Afghanistan veterans using mental health services?
Journal Name
Psychiatric Services
Journal Volume
64
Issue Number
2
Page Numbers
134-142
DOI
10.1176/appi.ps.004792011
Summary
As part of the National Post-Deployment Adjustment Study, 1,388 Veterans completed a survey to improve the understanding of mental health services use and perceived barriers to use in Iraq and Afghanistan Veterans. 43% of participants screened positive for posttraumatic stress disorder (PTSD), major depression, or alcohol abuse. Veterans with more severe PTSD and depression symptoms reported greater treatment utilization.
Key Findings
Forty-three percent screened positive for PTSD, major depression or alcohol abuse.
Veterans with more severe PTSD or depressive symptoms were significantly more likely to enter treatment; 69% of Veterans with probable PTSD and 67% with major depression reported accessing treatment in the past year, primarily through Veterans Affairs facilities.
Beliefs about the stigma of receiving treatment were more likely to be endorsed by Veterans who used treatment than by those who did not.
Veterans who did not access care, but screened positive for PTSD, depression, or alcohol misuse, were more likely to endorse the beliefs that individuals need to solve their own mental health problems and that taking medications will not help.
Implications for Program Leaders
Offer classes that teach skills in managing common mental health symptoms after deployment (e.g., sleep problems, low motivation)
Provide modules in their curricula about the courage involved in asking for help for mental health problems; such programming could focus on decreasing stigma surrounding mental health treatment
Disseminate information regarding the mental health services available to Service members and their families
Implications for Policy Makers
Continue to support a range of effective mental health services and programs aimed at reducing stigma
Continue to support pastoral care programs as well as the evaluation of such programs
Recommend education for service providers regarding the possible effects of deployment on Service member’s mental health
Methods
This study was part of the National Post-Deployment Adjustment Survey using a random sample of Veterans who served on or after September 11, 2001 and were separated from Active Duty or served in the Reserves or National Guard.
Participants completed a paper survey or an online survey that asked questions about mental health utilization, perceived treatment effectiveness, demographics, depression, alcohol abuse, and PTSD.
Surveys were sent to 2,499 Service members.
Participants
One thousand three hundred eighty-eight Veterans completed the survey (67% male).
A weight-adjusted sample of 1,102 Veterans was used to make the proportion of women (16%) comparable to U.S. Military.
The majority of participants were White (71%), married (61%), employed (78%), had some education beyond high school (81%), and were on average 36 years old.
Fifty-four percent were in the Army, 19% in the Air Force, 16% in the Navy, and 11% in the Marines; 52% were Active Duty, 26% had multiple deployments, and were deployed for an average of 9 months (SD = 8.90).
Limitations
All measures were self-report and may result in over or underreporting of symptoms or arrest history.
Participants were asked to recall service utilization for the past year and therefore, actual service utilization may not be accurately reflected.
It is unknown how non-responders differed from responders, therefore data could be biased.
Avenues for Future Research
Examine treatment use prospectively
Investigate the effectiveness of programs designed to reduce stigma and decrease barriers to care
Continue to examine barriers to care for Service members coping with mental health issues and ways reduce stigma within the military
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Objective: This study analyzed data from a national survey of Iraq and Afghanistan veterans to improve understanding of mental health services use and perceived barriers. Methods: The National Post-Deployment Adjustment Survey randomly sampled post-9/11 veterans separated from active duty or in the Reserves or National Guard. The corrected response rate was 56% (N=1,388). Results: Forty-three percent screened positive for posttraumatic stress disorder (PTSD), major depression, or alcohol misuse. Past year psychiatric treatment was reported by 69%of the PTSD group, 67% of the depression group, and 45% of those with alcohol misuse. Most received care at Veterans Affairs (VA) facilities, although women were more likely than men to seek non-VA services. Veterans with more severe symptoms reported greater treatment utilization. Eighteen percent saw a pastoral counselor (chaplain) in the past year. Veterans with mental health needs who did not access treatment were more likely to believe that they had to solve problems themselves and that medications would not help. Those who had accessed treatment were more likely to express concern about being seen as weak by others. Conclusions: Veterans in greatest need were more likely to access services. More than two-thirds with probable PTSD obtained past-year treatment,mostly at VA facilities. Treatment for veterans may be improved by increasing awareness of gender differences, integrating mental health and pastoral services, and recognizing that alcohol misuse may reduce utilization. Veterans who had and had not used services endorsed different perceptions about treatment, indicating that barriers to accessing care may be distinct from barriers to engaging in care.
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