Social Support and Mental Health Treatment Among Persons With PTSD: Results of a Nationally Representative Survey

Abstract

Objective Despite continued outreach efforts, levels of mental healthcare utilization for posttraumatic stress disorder (PTSD) remain low. As such, it is important to identify factors that may promote or discourage treatment engagement. The current study was designed to examine the association between perceived social support and utilization of several types of PTSD services. Methods Data come from the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), which was administered between 2004 and 2005. PTSD was assessed via structured interview, and perceived social support was assessed via the Interpersonal Support Evaluation List-12 (ISEL-12). Participants were asked about PTSD-specific treatment of the following modalities: outpatient, hospitalization, emergency department visits, and psychiatric medication prescriptions. Weighted logistic regression modeling was performed to examine associations between social support scores and the odds of receiving treatment for PTSD, adjusting for sociodemographic characteristics and PTSD severity. Results The final sample consisted of 2811 individuals with PTSD. Social support was not associated with the odds of receiving any type of PTSD treatment. Conclusions Among individuals in the general population with PTSD, perceived social support may not be related to PTSD treatment utilization. Other factors such as sociodemographic characteristics and symptom severity may be more important with respect to receiving PTSD-specific treatment.

Predictors of treatment utilization and unmet treatment need among individuals with posttraumatic stress disorder from a national sample

“…Findings that being non-Latino black and having less education were associated with a lower odds of treatment utilization among adults with past-year PTSD are similar to the findings for lifetime PTSD and lifetime treatment-seeking in the NCS-R by Wang et al [4] and in other nationally-representative studies [15, 17, 19]. The disparity in access to mental health treatment for PTSD for non-Latino blacks is reflective of a wide body of research documenting differential access to mental and general health services due to racial disparities [40, 41], and further emphasizes the need for policies and programs that address the social inequalities, such as differential access to housing and educational resources, that may underpin these and other findings [42].…”

“…The disparity in access to mental health treatment for PTSD for non-Latino blacks is reflective of a wide body of research documenting differential access to mental and general health services due to racial disparities [40, 41], and further emphasizes the need for policies and programs that address the social inequalities, such as differential access to housing and educational resources, that may underpin these and other findings [42]. Similar to findings from Sripada et al in the National Epidemiological Survey of Alcohol and Related Conditions (NESARC) [19], we found that being in the workforce or seeking work as compared to not being in the workforce were associated with both a lower odds of treatment utilization and a higher odds of unmet treatment need. That individuals in the workforce were both less likely to utilize treatment and more likely to report an unmet need for treatment suggests that structural barriers related to being in the workforce, rather than a lower perception of need, may be underlying reasons for differential utilization of mental health resources for this group.…”

“…The majority of past research in this area has focused on veteran and active military populations or survivors of man-made or natural disasters [14–16], groups with high trauma exposure and at high risk for PTSD, but from whom predictors may not be generalizable to other trauma-exposed populations. Five past studies have evaluated predictors of treatment utilization for PTSD in nationally-representative samples, reporting that, similar to research among those with general mental health needs, younger age [17], being male [18], having less education [4, 19], being non-Latino black [4, 17–19], being uninsured [19] and not having comorbid mental [17, 19] or physical [20] health conditions were predictors of low treatment utilization. However, dissimilar to research among those with general health mental health needs, these studies found that older age [4] and being married [17, 19] were also predictors of low treatment utilization.…”

“…While a few previous studies have evaluated predictors of treatment utilization among those with current PTSD, notably Sripada et al [19], the majority of past research in this area has been limitated due to the evaluation of lifetime PTSD and lifetime treatment, which does not adequately capture an estimate of prevalence of unmet need for treatment. The evaluation of lifetime PTSD and treatment seeking also introduces the potential for important predictors, such as current employment, to occur years after initial treatment-seeking.…”

Social networks, mental health problems, and mental health service utilization in OEF/OIF National Guard veterans

“…Although the relationship between social support and mental health conditions tends to be relatively consistent, findings on the relationship between social support and mental health service utilization remain equivocal [52,[65][66][67][68][69][70][71]. Social networks and perceived social support may have both stress-reducing functions (reducing the psychological impact of stress) and positive referral functions (encouraging treatment when it is needed) [63].…”