Publication year
2011
Citation Title
Mental health diagnosis and occupational functioning in National Guard/Reserve veterans returning from Iraq.
Journal Name
Journal of Rehabilitation Research & Development
Journal Volume
48
Issue Number
10
Page Numbers
1159-1170
DOI
10.1682/JRRD.2010.11.0212
Summary
Two hundred sixty-two Army National Guard Service members participated in a diagnostic interview and survey within one year of return from deployment to Iraq; they completed a survey one year later to examine the role of mental health diagnosis on occupational functioning. Army National Guard Service members with psychiatric diagnosis (posttraumatic stress disorder (PTSD), sub-threshold PTSD, major depression, or alcohol problems) are likely to struggle more with occupational functioning than service members without these diagnoses. However, thee diagnoses did not affect employment status.
Key Findings
Service members with a diagnosis of PTSD (5%), sub-threshold PTSD (6%), a major depressive disorder (11%), or alcohol use or dependence (11%) did not differ on employment status from Service members without a diagnosis.
Depression, PTSD, and alcohol use disorders all independently predicted lower rates of self-reported school and/or work role functioning.
Those diagnosed with mental health disorders were not less likely to be in school than those without these conditions.
Implications for Program Leaders
Continue to offer support for transitioning Service members by working with community agencies to maintain a list of local job openings
Offer workshops on time management and study skills to assist Service members living with depression, PTSD, and alcohol abuse to support them in their school and work functioning
Host workshops during reintegration to help families and Service members adjust to the Service member’s return, especially when the deployment has included combat exposure
Implications for Policy Makers
Continue to support employment programs for transitioning Service members, especially for those with mental health diagnoses
Continue to support programs that address the unique challenges faced by deployed Service members and their families
Recommend professional education, including information on military culture and transitioning out of military service, for professionals who work with Service members and their families
Methods
These data were part of prospective, longitudinal study of risk and protective factors associated with post-deployment functioning.
Participants were recruited from a group of 355 Army NGR Service members deployed to OIF between March 2006 and July 2007.
Participants completed structured diagnostic interviews and self-reported measures on a range of domains (PTSD, depression, alcohol use, social adjustment, employment status, and combat experiences) within 1 year of their deployment to Iraq and again 1 year later via a mailed survey
Participants
Two hundred sixty-two Army National Guard Service members participated (88% male).
Ninety-four percent of the sample identified as White, the average agewas 30.47 years (SD = 8.73), and 54% were married.
Eighty-six percent enlisted, 45% were combat arms, and 40% were combat service support.
Limitations
The sample size is modest and was drawn from one National Guard brigade team that is mostly White, able bodied, and male; results may not generalize to other populations of Service members.
Occupational functioning was evaluated entirely by self-report and may be subject to self-reporting bias.
Some of the employment data could be due to its collection during a period of economic decline and could skew the findings.
Avenues for Future Research
Examine occupational functioning and mental health diagnoses over time using non-self-report measures such as employer ratings
Gather data from those with mental health diagnoses and impaired work functioning to see what predicts impairment
Replicate the study with a sample that has more gender and ethnic diversity
Focus
Army
Target Population
Population Focus
Military Branch
Military Component
Abstract
Occupational functioning represents both an important outcome for military service members returning from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom and a predictor for long-term mental health functioning. We investigated the role of mental health diagnoses, determined by structured clinical interviews, on occupational functioning in a group of 262 National Guard/Reserve service members within 1 year of returning from a 16-month OIF combat deployment. We assessed occupational functioning at the time of diagnostic interviews and 1 year later. We hypothesized that service members with diagnoses of posttraumatic stress disorder (PTSD), depression, and/or alcohol abuse or dependence would exhibit lower rates of employment at both time points and lower rates of reported work and/or school role functioning. Service members with a diagnosis of PTSD (5%, n = 13), subthreshold PTSD (6%, n = 15), a major depressive disorder (11%, n = 29), or alcohol abuse or dependence (11%, n = 28) did not differ on employment status from service members without a diagnosis at either time point. However, those with a diagnosis of PTSD, depression, and/or alcohol abuse or dependence reported lower levels of work role functioning. In addition, service members with a diagnosis of PTSD reported greater rates of deterioration in work role functioning over time.
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