Reported Barriers to Mental Health Care in Three Samples of U.S. Army National Guard Soldiers at Three Time Points

Abstract

The military community and its partners have made vigorous efforts to address treatment barriers and increase appropriate mental health services use among returning National Guard soldiers. We assessed whether there were differences in reports of treatment barriers in 3 categories (stigma, logistics, or negative beliefs about treatment) in sequential cross-sectional samples of U.S. soldiers from a Midwestern Army National Guard Organization who were returning from overseas deployments. Data were collected during 3 time periods: September 2007-August 2008 (n = 333), March 2009-March 2010 (n = 884), and August 2011-August 2012 (n = 737). In analyses using discretized time periods and in trend analyses, the percentages of soldiers endorsing negative beliefs about treatment declined significantly across the 3 sequential samples (19.1%, 13.9%, and 11.1%). The percentages endorsing stigma barriers (37.8%, 35.2%, 31.8%) decreased significantly only in trend analyses. Within the stigma category, endorsement of individual barriers regarding negative reactions to a soldier seeking treatment declined, but barriers related to concerns about career advancement did not. Negative treatment beliefs were associated with reduced services use (OR = 0.57; 95% CI [0.33, 0.97]).

Examining the effectiveness of an intensive, 2‐week treatment program for military personnel and veterans with PTSD: Results of a pilot, open‐label, prospective cohort trial

“…Critically, outcomes of the present study are comparable to those observed in studies and settings employing more traditional treatment models (e.g., weekly or biweekly sessions), which suggests that CPT retains its efficacy even when administered intensively during very brief periods of time. If replicated, these findings may point to an alternative treatment delivery model that could increase treatment accessibility for many military personnel and veterans with PTSD, a population with relatively low rates of mental healthcare utilization (Hoge et al., ; Maguen, Madden, Cohen, Bertenthal, & Seal, ; Valenstein et al., ). The 2‐week intensive program was associated with higher treatment completion rates and lower dropout rates as compared with reported rates in many clinical trials and naturalistic studies for trauma‐focused therapy (see Imel, Laska, Jakcupcak, & Simpson, , for review).…”

Determinants of National Guard Mental Health Service Utilization in VA versus Non‐VA Settings

“…Prior analysis demonstrated that the prevalence of mental health concerns 12 months postdeployment did not change for serial panel cohorts 45–90 days postdeployment, with 15.8 and 19.0 percent having PTSD and depression symptoms, respectively (Valenstein et al. ). Looking over time at changes in outcomes within individuals who are engaged in VA and non‐VA care is an important next step.…”

“…; Valenstein et al. ). Prior research has also found that those with PTSD have high levels of comorbid major depressive disorder and alcohol‐use disorder (Erbes et al.…”

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

“…Data were collected under an approved waiver of written informed consent. For further details of the study, please see [83,84].…”

“…Mental health service utilization in the past year was assessed from 14 items that asked participants to indicate if they ''had received mental health services for a stress, emotional, alcohol, or family problem'' from either general medical or mental health providers in several different settings, including military, civilian, Veterans Affairs health clinics, or Vet Centers (see [83]). An affirmative response to receiving treatment from any of these providers in the past year was used to create a dichotomous variable reflecting any mental health treatment.…”