Longitudinal determinants of mental health treatment-seeking by
                        US soldiers

Adler, Amy B.; Britt, Thomas W.; Riviere, Lyndon A.; Kim, Paul Y.; Thomas, Jeffrey L.

doi:10.1192/bjp.bp.114.146506

Cited by 77 publications

(70 citation statements)

References 38 publications

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“…This item is closely aligned with recently published research demonstrating that preference for self-management of mental health care related to nearly 50% lower use of treatment in the next year in a sample of U.S. Soldiers (Adler et al, 2015). …”

Section: Methodssupporting

confidence: 84%

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Improving Mental Health Treatment Utilization in Military Veterans: Examining the Effects of Perceived Need for Care and Social Support

Graziano

Elbogen

2017

Military Psychology

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Objective Many veterans with mental health problems do not adequately utilize needed care. Research has focused on identifying barriers to mental health care in veterans. Method The current study adds to existing literature by examining whether perceived need for treatment and social support affect treatment utilization in a national longitudinal survey of Iraq and Afghanistan veterans (n = 1090). Results The Health Beliefs Model (HBM) postulates that a key reason why patients fail to obtain needed care is their belief "it's up to me to handle my own problems." This view was endorsed by 42% in the current national sample of veterans and was found in multivariate analysis to predict less treatment seeking in the next year. Mediation analysis revealed that veterans with higher ratings of social support were less likely to believe they needed to solve mental health problems on their own, indirectly equating to higher odds of treatment use. Simultaneously, findings indicated that posttraumatic stress disorder (PTSD) had a direct effect on more mental health visits but was also associated with higher endorsement that one needed to handle one's own problems and thus had an indirect effect of reducing mental health visits. Conclusion Both social support and PTSD affected veterans' perceptions of needing to solve one's own problems, significantly predicted follow-up with mental health care. As a result, the findings indicate that clinicians' should explore veterans' belief systems about perceived treatment need as well as investigate the role of social support to improve mental health treatment utilization.

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Section: Methodssupporting

confidence: 84%

“…Indeed, a recent study showed that U.S. Soldiers who said they preferred to manage problems on their own had worse treatment seeking in the next year (Adler et al, 2015). Another study of U.S Soldiers found a similar result in that soldiers’ feeling that they could handle problems on their own was a common reason for dropout (Hoge et al, 2014).…”

mentioning

confidence: 99%

Improving Mental Health Treatment Utilization in Military Veterans: Examining the Effects of Perceived Need for Care and Social Support

Graziano

Elbogen

2017

Military Psychology

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“…A single survey item (based on work by Adler et al, 2015;Hoge, Grossman, et al, 2014;Kim et al, 2011;and Wright et al, 2009) asked respondents about 13 perceived barriers to care, with an additional option to mark "other." Table 6.57 displays the results, ordered by the most-popular reasons.…”

Section: Reasons For Not Receiving Needed Services For Mental Health mentioning

confidence: 99%

2015 Department of Defense Health Related Behaviors Survey (HRBS)

Meadows¹,

Engel²,

Collins³

et al. 2018

154

165

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This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial use. For information on reprint and linking permissions, please visit www.rand.org/pubs/permissions.The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest.RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.Support RAND Make a tax-deductible charitable contribution at www.rand.org/giving/contribute www.rand.org Library of Congress Cataloging-in-Publication Data For more information on this publication, visit www.rand.org/t/RR1695Published by the RAND Corporation, Santa Monica, Calif. © Copyright 2018 RAND CorporationR® is a registered trademark. Cover photo credits from top to bottom:Photo by Cpl PrefaceThe Health Related Behaviors Survey (HRBS) is the U.S. Department of Defense's flagship survey for understanding the health, health-related behaviors, and well-being of service members. Originally implemented to assess substance use (i.e., illicit drugs, alcohol, and tobacco), the survey now includes content areas-such as mental and physical health, sexual behavior, and postdeployment problems-that may affect force readiness or the ability to meet the demands of military life. The HRBS is intended to supplement administrative data already collected by the armed forces. In 2014, the Defense Health Agency asked the RAND Corporation to review previous iterations of the HRBS, update survey content, administer a revised version of the survey, and analyze data from the resulting 2015 HRBS of active-duty personnel. The 2015 HRBS included U.S. Air Force, Army, Marine Corps, Navy, and Coast Guard personnel, and this report details the survey methodology and results. No expertise in health, health-related behaviors, or health care is required to read this report. However, it may be of most use to individuals who provide direct care related to the health and health-related behaviors of active-duty service members or who are responsible for making related policy decisions. Additional information can be found in a series of online appendixes.This research was sponsored by the Defense Health Agency and conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelli...

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“…The unwillingness to see the tailored advice might be due to lack of interest, mistrust of health services, fear of receiving bad news and a conviction that mental health issues are not personally relevant. 32,33 One of the criteria for introducing screening for a condition is that the natural history of the condition should be adequately understood. Screening may not work for PTSD in particular because of the diversity of trajectories of the condition over time, 34,35 even over a short period.…”

Section: Discussionmentioning

confidence: 99%

Post-deployment screening for mental disorders and tailored advice about help-seeking in the UK military: a cluster randomised controlled trial

et al. 2017

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Longitudinal determinants of mental health treatment-seeking by US soldiers

Abstract: Results demonstrate the importance of broadening the conceptualisation of barriers and facilitators of mental healthcare beyond stigma. Techniques and delivery models emphasising self-care may help increase soldiers' interest in using mental health services.

Cited by 77 publications

References 38 publications

Improving Mental Health Treatment Utilization in Military Veterans: Examining the Effects of Perceived Need for Care and Social Support

Improving Mental Health Treatment Utilization in Military Veterans: Examining the Effects of Perceived Need for Care and Social Support

2015 Department of Defense Health Related Behaviors Survey (HRBS)

Post-deployment screening for mental disorders and tailored advice about help-seeking in the UK military: a cluster randomised controlled trial

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