Barriers to mental healthcare services are reported among military service members. However, little is known about these barriers among the spouses of military personnel, who face unique stressors and may subsequently be at high-need for mental health services. Understanding barriers to care among this vulnerable population may help improve access to psychological services. The current study utilized data from the Millennium Cohort Family Study. Participants were referred by their military spouses or through targeted mailers. Participants completed self-report measures of mood, psychosocial functioning, and perceived barriers to mental healthcare via web-or paper-based surveys. A factor analysis was conducted to identify subscales of the barriers to mental healthcare measure, and logistic regressions were conducted adjusting for relevant sociodemographic variables, to determine psychosocial factors associated with likelihood of reporting barriers to mental healthcare. The sample comprised 9,666 military spouses (86% female; M age : 27.73 ± 5.09; 29.2% racial/ethnic minority; 19.5% with prior/current military service). Logistic factors were the most frequently reported barrier to care (63%), followed by negative beliefs about mental healthcare (52%), fear of social/occupational consequences (35%), and internalized stigma (32%). Spouses with prior or current military service themselves and individuals with a psychiatric condition were most likely to report barriers to mental healthcare. A preponderance of military spouses reported barriers to mental healthcare services. Prospective data are needed to elucidate the associations between barriers to care and mental healthcare utilization. Efforts may be warranted to improve access to mental healthcare among the spouses of military personnel. Impact StatementThe elucidation of barriers to mental healthcare among military spouses, a population vulnerable to stress and psychopathology, is critical to optimizing the health of the military family and ensuring military readiness. The current study found that logistic factors, such as lack of time or cost of services, and negative attitudes toward mental healthcare were frequently reported barriers to care. The integration of behavioral health into primary care settings may help to alleviate some of these barriers, though additional data are warranted.
The loss-of-load expectation (LOLE) risk metric has been used in probabilistic power system resource adequacy assessment for over 70 years, and today is one of the most recognizable and widely-used measures of system shortfall risk. However, this wide adoption has been accompanied by ambiguities and inconsistencies in its definition and application. This paper provides a unifying reference for defining the metric as it relates to modern analyses, while clarifying a number of common points of confusion in its application. In particular, the paper clarifies that LOLE is not a measure of expected total shortfall duration, a 2.4 hours per year LOLE target implies a less reliable system than a 1 day in 10 years (0.1 days per year) LOLE target, and exact conversions between hourly and daily LOLE targets are not generally possible. Illustrative examples are provided to help explain each of these points.
The loss-of-load expectation (LOLE) risk metric has been used in probabilistic power system resource adequacy assessment for over 70 years, and today is one of the most recognizable and widely-used measures of system shortfall risk. However, this wide adoption has been accompanied by ambiguities and inconsistencies in its definition and application. This paper provides a unifying reference for defining the metric as it relates to modern analyses, while clarifying a number of common points of confusion in its application. In particular, the paper clarifies that LOLE is not a measure of expected total shortfall duration, a 2.4 hours per year LOLE target implies a less reliable system than a 1 day in 10 years (0.1 days per year) LOLE target, and exact conversions between hourly and daily LOLE targets are not generally possible. Illustrative examples are provided to help explain each of these points.
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