Predictors of mental health care use among male and female veterans deployed in support of the wars in Afghanistan and Iraq.

Leone, Brooke A. L. Di; Vogt, Dawne; Gradus, Jaimie L.; Street, Amy E.; Giasson, Hannah L.; Resick, Patricia A.

doi:10.1037/a0032088

Cited by 27 publications

(54 citation statements)

References 34 publications

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“…Contrary to our hypothesis that suicidal individuals receiving the intervention would seek mental health treatment most frequently, no significant difference in treatment seeking behaviors was found between the intervention and control groups for suicidal participants. Our findings support previous research that greater symptom severity predicts treatment utilization (Di Leone et al, 2013; Elbogen et al, 2013; Haskell et al, 2011). …”

Section: Discussionsupporting

confidence: 91%

“…Suicidal ideation significantly increases the risk of suicide attempts and eventual death by suicide (Kessler et al, 2005). It is noteworthy that greater mental health symptom severity predicts increased use of VHA services among OEF/OIF Veterans (Di Leone et al, 2013; Elbogen et al, 2013; Haskell et al, 2011). In a study of 1,388 OEF/OIF Veterans, 69% with PTSD and 67% with depression reported past year psychiatric treatment (Elbogen et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…Psychiatric comorbidity, polytrauma exposure, and time since military separation are the best predictors of initial engagement in needed mental health treatment (Hearne, 2013). In a sample of 1,040 OEF/OIF Veterans, more PTSD symptomatology and positive perceptions of the VA were associated with use of VHA mental health services (Di Leone et al, 2013). Examining time since military separation, Hoge, Auchterlonie, and Milliken (2006) found that 35% of OIF Veterans accessed mental health services in the year after returning home.…”

Section: Introductionmentioning

confidence: 99%

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Improving Treatment Engagement for Returning Operation Enduring Freedom and Operation Iraqi Freedom Veterans With Posttraumatic Stress Disorder, Depression, and Suicidal Ideation

Gallegos

Streltzov

Stecker

2016

Journal of Nervous &Amp; Mental Disease

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Posttraumatic stress disorder (PTSD) is associated with increased risk of suicidal ideation among Veterans of Iraq and Afghanistan (OEF/OIF). This report examined the effectiveness of a brief phone-based cognitive-behavioral intervention on treatment seeking among suicidal and non-suicidal OEF/OIF Veterans who screened positive for PTSD. Participants were randomized to the intervention or control conditions. We found that suicidal participants, regardless of condition, were twice as likely to attend treatment as non-suicidal participants. Participants assigned to the control condition who did not indicate suicidality at baseline were less likely to attend treatment at both the 1 and 6 month follow-up interviews. Qualitative findings of the suicidal participants indicated PTSD and depressive symptomatology, low social support, and infrequent positive coping mechanisms. Our finding indicates the effectiveness of an intervention to motivate Veterans with PTSD to initiate and remain in treatment. The intervention might be particularly useful prior to experiencing a psychological crisis.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Improving Treatment Engagement for Returning Operation Enduring Freedom and Operation Iraqi Freedom Veterans With Posttraumatic Stress Disorder, Depression, and Suicidal Ideation

Gallegos

Streltzov

Stecker

2016

Journal of Nervous &Amp; Mental Disease

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“…As stated, the variables representing need for care, including decreased rating of one’s health and increased level of disability, both predicted increases in help seeking as expected based on previous research 12 . The enabling factors in this study, including income and distance to closest VA, were also significant predictors of service use.…”

Section: Discussionsupporting

confidence: 70%

“…This study also found that need-based variables were the most significant predictors of utilization. Although the model has not been formally tested in OIF-OEF veterans, a recent study of mental health care utilization in returning veterans found that probable need for services, income, combat exposure, and perceptions of VA care were significantly related to use 12 .…”

mentioning

confidence: 99%

Veterans' Preferences for Receiving Information About VA Services: Is Getting the Information You Want Related to Increased Health Care Utilization?

et al. 2016

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Although the current cohort of returning veterans has engaged more fully with care from the Department of Veterans Affairs (VA) than have veterans from previous eras, concern remains regarding low engagement with VA services,1 particularly for specialty services for diagnoses that can most negatively impact quality of life. The current study used the framework of the Andersen model2 to examine factors related to VA healthcare use in Operation Enduring Freedom/Operation Iraqi Freedom (OEF-OIF) veterans. Match between veterans’ preferences for source of information about VA programs and veterans’ actual sources of information about VA services was examined as an additional predictor of help seeking. The study included 1,161 veterans recruited from the southeast United States. Results suggested that veterans prefer to receive information from VA publications and the web, while they actually receive information from VA publications and other veterans. Logistic regression suggested that number of deployments, income, distance to VA, VA disability rating, self-rated health, and match between preferred source of information and actual source of information were significantly related to use of VA services since deployment. These results suggest that future outreach efforts should focus on targeting veterans’ health needs and preferences for care and source of information.

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Propensity of US Military Personnel to Seek Mental Health Care When Community Psychiatric Capacity Changes

Shen,

Bacolod,

Heissel

2023

JAMA Health Forum

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ImportanceUnderstanding how the active duty military population’s mental health care use is associated with local military and civilian psychiatrist capacity is critical in designing the optimal allocation of mental health resources from both sectors to improve the mental health of military personnel.ObjectiveTo evaluate whether the probability of mental health care visits by military personnel changes when psychiatrist capacity changes in their communities, when capacity is measured separately for military treatment facilities and civilian sectors.Design, Setting, and ParticipantsThis cohort study of active duty US military service members between January 1, 2016, and September 30, 2020, combines data from the Defense Health Agency, the National Plan and Provider Enumeration System, and the US Census. Data were collected and analyzed from June 2022 to July 2023.Main Outcomes and MeasuresThe main outcome was the probability of making at least 1 mental health care visit in a given quarter at military treatment facilities and in civilian settings. Linear probability models with 2-dimensional fixed effects at individual and community levels were implemented to estimate changes in individual outcomes when community psychiatrist capacity changed.ResultsThis study includes 1 958 421 US service members (83% men; mean [SD] age at baseline, 28.4 [8.0] years). Thirteen percent of service members did not have military treatment facility psychiatrists available within a 30-minute driving time, and 66% lived in communities with a psychiatrist shortage (&lt;1 psychiatrist per 20 000 relevant population), while 9% lived in communities with high (&gt;3 psychiatrists per 20 000 relevant population) military treatment facility psychiatrist capacity. Five percent of service members lived in communities with no civilian psychiatrists within a 30-minute driving time, while 66% lived in communities with high civilian psychiatrist capacity. The mean quarterly mental health care visit rates to military treatment facilities and civilian settings were 7% and 2%, respectively. The probability of a mental health care visit to a military treatment facility increased by 0.95 percentage points (95% CI, 0.79-1.10 percentage points; equivalent to 14%) when the individual experienced a change in military treatment facility capacity from no psychiatrist to high capacity. The probability of a mental health care visit to a civilian setting increased by 0.57 percentage points (95% CI, 0.38-0.76 percentage points; equivalent to 32%) when civilian capacity changed from no psychiatrist to high capacity. The magnitude of responses to military treatment facility capacity changes remained similar in communities that already had high civilian capacity.Conclusions and RelevanceThis cohort study of the US military population suggests that active duty military personnel rely largely on military treatment facilities for their mental health care and that there are meaningful responses to military treatment facility psychiatrist capacity changes even in communities with high civilian psychiatric capacity. Realigning military treatment facility psychiatrists across communities with shortages and high-capacity military treatment facilities, as well as addressing nongeographical barriers in the civilian sector, remain critical to achieve the optimal balance between military and civilian care provision.

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Predictors of mental health care use among male and female veterans deployed in support of the wars in Afghanistan and Iraq.

Cited by 27 publications

References 34 publications

Improving Treatment Engagement for Returning Operation Enduring Freedom and Operation Iraqi Freedom Veterans With Posttraumatic Stress Disorder, Depression, and Suicidal Ideation

Improving Treatment Engagement for Returning Operation Enduring Freedom and Operation Iraqi Freedom Veterans With Posttraumatic Stress Disorder, Depression, and Suicidal Ideation

Veterans' Preferences for Receiving Information About VA Services: Is Getting the Information You Want Related to Increased Health Care Utilization?

Propensity of US Military Personnel to Seek Mental Health Care When Community Psychiatric Capacity Changes

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