Evaluation of universal screening for military-related sexual trauma.
OBJECTIVE
In response to growing concerns about sexual violence as an underrecognized traumatic consequence of military service, Veterans Health Administration policy requires universal screening for sexual trauma sustained during military service. This prospective study, the first to evaluate national efforts to screen for military sexual trauma, investigated whether sexual trauma screening is associated with increased utilization of mental health services.


METHODS
This study examined data for all male (N=540,381) and female (N=33,259) veterans who had valid responses to screens for military sexual trauma in 2005. The use of mental health services during the three months after screening was examined for persons who screened positive for military sexual trauma and for those who screened negative. Findings were stratified by use of mental health services in the six months before the screening.


RESULTS
Compared with negative screens, positive screens were associated with significantly increased rates of postscreen mental health treatment. A more than twofold increase was observed for patients without previous use of mental health treatment (women: relative risk [RR]=2.52, 95% confidence interval [CI]= 2.38-2.66; men: RR=2.47, 95% CI=2.34-2.61). In this group, the number of positive screens needed for one additional patient to access treatment was 5.5 for women and 7.2 for men.


CONCLUSIONS
Our findings suggest that detection via screening is associated with increased rates of mental health treatment. An effective screening program that promotes detection of sexual trauma and access to mental health care can help to reduce the burden of psychiatric illness for those who have experienced military sexual trauma.
National Center for PTSD, Department of Veterans Affairs (VA) Palo Alto Health Care System, Menlo Park, CA 94131, USA. rachel.kimerling@va.gov
Rachel
R
Kimerling
Amy E
AE
Street
Kristian
K
Gima
Mark W
MW
Smith
D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008605:Mental Health Services / Q000706:statistics & numerical data; D008889:Military Personnel / Q000523:psychology*; D015397:Program Evaluation; D011446:Prospective Studies; D012742:Sex Offenses / Q000523:psychology*; D014947:Wounds and Injuries / Q000523:psychology*