Publication year
2011
Citation Title
National Guard families after combat: Mental health, use of mental health services, and perceived treatment barriers.
Journal Name
Psychiatric Services
Journal Volume
62
Issue Number
1
Page Numbers
28-34
DOI
10.1176/ps.62.1.pss6201_0028
Summary
Mental health symptoms, use of provided mental health services, and perceived barriers to service utilization were assessed among members of the National Guard and their spouses/partners. In this sample, over a third of participants indicated having at least one mental health problem. Service members most often cited embarrassment-related reasons for not utilizing mental health care, whereas female partners indicated more pragmatic reasons for not utilizing these services.
Key Findings
Forty percent of National Guard members and 34% of partners met diagnostic criteria for at least one mental health problem, including: depression (21%), PTSD (14%), alcohol abuse (14%), suicidal ideation (7%), and alcohol abuse (14%).
Of those with a mental health problem, 47% did not utilize services of a mental health care professional.
Soldiers with mental health problems were more likely to cite the following barriers to utilizing services: embarrassment, fear of it harming ones career, being seen differently by leaders, or seen as weak.
Partners with mental health problems were more likely to cite pragmatic barriers to utilizing mental health services: difficulty scheduling an appointment, cost, and having to drive a great distance.
Implications for Program Leaders
Disseminate information regarding mental health service options could help de-stigmatize services and provide an avenue for accessing care
Offer options for mental health self-assessment during programming and make referrals
Offer support groups for military families coping with mental health issues
Implications for Policy Makers
Continue to support programs that offer military families on-installation mental health services
Encourage collaboration between DoD and community counseling services to allow military families to utilize non-military private counseling services
Recommend professional education to service providers working with military families regarding the unique issues military families face
Methods
Participants were National Guard members recruited from nine different reintegration workshops held in 2007 and 2008 in the Midwest following the return from a 12-month deployment.
Service members and their significant others were invited to participate.
Data were collected following the adjournment of the workshop.
Participants
Three hundred thirty-two National Guard members (response rate = 40%) and 212 significant others (36%) completed surveys.
The majority of participants were between the ages of 18-60 (81%) and were predominantly White (80%), followed by Black (11%) and Latino/Latina (2%), Native American (2%), Asian-American (2%), and other (2%).
Most Service members were enlisted (81%), followed by officer 01-09 (18%) and warrant officers (1%).
Limitations
This sample was disproportionately composed of young, married National Guard members from racial-ethnic minority groups, so findings may not generalize to the National Guard as a whole.
The use of self-report measures may limit the interpretation of the findings.
The use of cross-sectional data at one time-point shortly after deployment make it inappropriate to draw conslusions about long-term help-seeking behaviors.
Avenues for Future Research
Utilize a more representative sample of the National Guard to determine whether findings are replicated in a broader sample
Explore how more recent National Guard returnees function after deployment
Continue to examine the common barriers to help-seeking and ways to reduce stigma regarding mental health in the military
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
Objective: National Guard forces have deployed in large numbers to Iraq and Afghanistan since September 11, 2001. The purpose of this cross-sectional study was to assess mental health symptoms, utilization of mental health services, and perceived barriers to service use among National Guard members and their significant others (including spouses and others with whom they share a committed relationship) from a Midwestern state. Methods: Participants were recruited for the study at military-sponsored reintegration workshops, which took place 45-90 days after service members' return from deployment. A sample of 332 National Guard members and 212 significant others volunteered to complete a survey that assessed mental health symptoms, service utilization, and barriers to treatment. Results: Forty percent of National Guard members and 34% of significant others met the screening criteria for one or more mental health problems. Of those meeting the criteria, 53% reported seeking help of some kind (50% of soldiers; 61% of significant others). Stigma associated with mental health care and concerns about service utilization appearing on military records ranked high as barriers among service members. Concerns about the influence of mental health issues on career advancement were of note. For significant others, barriers included the costs of mental health care, trouble with scheduling appointments, difficulty in getting time off work, and not knowing where to get help. Conclusions: The mental health effects of combat on the soldier and his or her significant other remain a challenge for National Guard families, who often reside in communities that show little understanding of the psychological costs of war. Barriers remain for mental health service utilization.
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