VA mental health services utilization in Iraq and Afghanistan veterans in the first year of receiving new mental health diagnoses

Seal, Karen H.; Maguen, Shira; Cohen, Beth E.; Gima, Kristian; Metzler, Thomas J.; Li, Ren; Bertenthal, Daniel; Marmar, Charles R.

doi:10.1002/jts.20493

Cited by 369 publications

(323 citation statements)

References 45 publications

(53 reference statements)

Supporting

Mentioning

305

Contrasting

Order By: Relevance

“…This study's path from psychological symptoms in emerging adulthood to psychiatric disorders and mental health services utilization in the mid-30s was consistent with the findings of other investigators. 26,27,63 Our findings demonstrated that psychological symptoms are related to physical diseases and symptoms, which, in turn, are associated with psychiatric disorders. According to Rumsfeld and his colleagues, 29 "depressive symptoms are the strongest predictors of short-term declines in health status in patients with heart failure."…”

Section: Discussionmentioning

confidence: 54%

Utilization of Mental Health Services by Minority Urban Adults: Psychosocial Predictors

et al. 2014

View full text Add to dashboard Cite

Although most mental disorders have their first onset by young adulthood, there are few longitudinal studies of these problems and related help-seeking behavior. The present study examined some early and current predictors of the use of mental health services among African-American and Puerto Rican participants in their mid-30s. The 674 participants (52.8 % African Americans, 47.2 % Puerto Ricans; 60.1 % women) in this study were first seen in 1990 when the participants attended schools serving the East Harlem area of New York City. A structural equation model controlling for the participants' gender, educational level in emerging adulthood, and age at the most recent data collection showed significant standardized pathways from both ethnicity (β=−0.28; z= −4.82; pG0.001) and psychological symptoms (β=0.15; z=2.41; pG0.05), both measured in emerging adulthood, to smoking in the early 30s. That, in turn, was associated with certain physical diseases and symptoms (i.e., respiratory) in the mid-30s (β=0.16; z=2.59; pG0.05). These physical diseases and symptoms had a cross-sectional association with family financial difficulty in the mid-30s (β=0.21; z=4.53; pG0.001), which in turn also had a cross-sectional association with psychiatric disorders (β=0.30; z=5.30; pG0.001). Psychiatric disorders had a cross-sectional association with mental health services utilization (β=0.65; z=13.25; pG0.001). Additional pathways from the other domains to mental health services utilization in the mid-30s were also supported by the mediating role of psychiatric disorders. Results obtained from this research offer theoretical and practical information regarding the processes leading to the use of mental health services.

show abstract

Section: Discussionmentioning

confidence: 54%

Utilization of Mental Health Services by Minority Urban Adults: Psychosocial Predictors

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Though assessments of MH use among OEF/OIF veterans found 35 % accessed MH services in the year returning home, 27 research on OEF/OIF veterans using VA care found that only a minority of this group received the full recommended number and intensity of MH treatment sessions within the first year of diagnosis. 12 This suggests that research directed 30 A recent review of research on MH beliefs and service use among veterans and military personnel identified several gaps in the current literature that provide direction for future research. 31 Gaps included lack of attention to the association between MH beliefs and service use, a limited focus on personal beliefs about mental illness and MH treatment, and the use of unvalidated measures of MH beliefs as limitations that need addressing with future studies.…”

Section: Discussionmentioning

confidence: 99%

“…10,11 Mental health (MH) services use has been examined in single war era veteran cohorts and among VA users, but this does not reflect the experiences of the larger population of veterans. 12 The prevalence of PTSD and of MH treatment in the general women veteran population is unknown.…”

Section: Introductionmentioning

confidence: 99%

PTSD Risk and Mental Health Care Engagement in a Multi-War Era Community Sample of Women Veterans

et al. 2013

View full text Add to dashboard Cite

BACKGROUND: Post-traumatic stress disorder (PTSD) is common in women veterans (WVs), and associated with significant co-morbidity. Effective treatment is available; however, PTSD is often unrecognized. OBJECTIVES: Identify PTSD prevalence and mental healthcare (MHC) use in a representative national WV sample. DESIGN AND PARTICIPANTS: Cross-sectional, population-based 2008-2009 national survey of 3,611 WVs, weighted to the population. MAIN MEASURES: We screened for PTSD using a validated instrument, and also assessed demographic characteristics, health characteristics, and MHC use in the prior 12 months. Among those screening positive, we conducted multivariate logistic regression to identify independent predictors of MHC use. KEY RESULTS: Overall, 13.0 % (95 % confidence interval [CI] 9.8-16.2) of WVs screened PTSD-positive. Veterans Health Administration (VA) healthcare was used by 31.1 % of PTSD-positives and 11.4 % of PTSD-negatives (p<0.001). Among those screening positive, 48.7 % (95 % CI 35.9-61.6) used MHC services (66.3 % of VA-users, 40.8 % of VA-nonusers; p<0.001). Having a diagnosis of depression (OR=8.6; 95 % CI 1.5-48.9) and VA healthcare use (OR=2.7; 95 % CI 1.1-7.0) predicted MHC use, whereas lacking a regular provider for health care (OR=0.2; 95 % CI 0.1-0.4) and household income below the federal poverty level (OR=0.2; 95 % CI 0.1-0.5) predicted nonuse. CONCLUSIONS: More than one in eight WVs screened positive for PTSD. Though a majority of VA-users received MHC, low income predicted nonuse. Only a minority of VA-nonusers received MHC. The majority of WVs use non-VA healthcare providers, who may be unaware of their veteran status and PTSD risk. VA outreach to educate VA-nonusers and their healthcare providers about WVs' PTSD risk and available evidencebased VA treatment options is one approach to extend the reach of VA MHC. Research to characterize barriers to VA MHC use for VA-nonusers and low income VAusers is warranted to better understand low service utilization, and to inform program development to engage more WVs in needed MHC.

show abstract

“…Studies show that many post-9/11 veterans opt against seeking mental health services due to concerns about stigma, privacy, and confidentiality; career-related issues including jeopardizing promotion; and a preference for relying upon personal resources and coping strategies [32,71,72]. Coaching into Care is a program that helps families and loved ones by providing information, resources, and instructions framed in terms adapted from motivational interviewing; the goal of the program is to help service members and veterans overcome reluctance to seek out mental health care and connect with appropriate resources [73].…”

Section: Dod and Vha Collaborationsmentioning

confidence: 99%

Mental Health Among Military Personnel and Veterans

Pickett¹,

Rothman²,

Crawford³

et al. 2015

North Carolina Medical Journal

View full text Add to dashboard Cite

VA mental health services utilization in Iraq and Afghanistan veterans in the first year of receiving new mental health diagnoses

Cited by 369 publications

References 45 publications

Utilization of Mental Health Services by Minority Urban Adults: Psychosocial Predictors

Utilization of Mental Health Services by Minority Urban Adults: Psychosocial Predictors

PTSD Risk and Mental Health Care Engagement in a Multi-War Era Community Sample of Women Veterans

Mental Health Among Military Personnel and Veterans

Contact Info

Product

Resources

About