title: Association of perceived barriers with prospective use of VA mental health care among Iraq and Afghanistan veterans.
abstract: OBJECTIVE
  The relationship between perceived barriers and prospective use of mental health care among veterans was examined.
  
  
  METHODS
  The sample included Iraq and Afghanistan veterans (N=305) who endorsed symptoms of depression or posttraumatic stress disorder (PTSD) or alcohol misuse at intake to a postdeployment clinic between May 2005 and August 2009. Data on receipt of adequate treatment (nine or more mental health visits in the year after intake) were obtained from a VA database.
  
  
  RESULTS
  Adequate treatment was more likely for women (odds ratio [OR]=4.82, 95% confidence interval (CI)=1.37-16.99, p=.014) and for those with more severe symptoms of PTSD (OR=1.03, CI=1.01-1.05, p=.003) and depression (OR=1.06, CI=1.01-1.11, p=.01). Perceived barriers were not associated with adequate treatment.
  
  
  CONCLUSIONS
  Male veterans with mental health problems should be targeted with outreach to reduce unmet need. Research is needed to identify perceived barriers to treatment among veterans.
authors.affiliation: US Department of Veterans Affairs Puget Sound Healthcare System, Seattle Division, 1660 South Columbian Way S-116, Seattle, WA 98108, USA. katherine.hoerster@va.gov
authors.forename: Katherine D
authors.initials: KD
authors.lastname: Hoerster
authors.forename: Carol A
authors.initials: CA
authors.lastname: Malte
authors.forename: Zachary E
authors.initials: ZE
authors.lastname: Imel
authors.forename: Zeba
authors.initials: Z
authors.lastname: Ahmad
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Hunt
authors.forename: Matthew
authors.initials: M
authors.lastname: Jakupcak
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000346:Afghanistan; D000437:Alcoholism / Q000628:therapy; D016001:Confidence Intervals; D003863:Depression / Q000628:therapy; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007493:Iraq; D054542:Iraq War, 2003-2011; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008889:Military Personnel / Q000523:psychology*; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D057545:Social Stigma; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy; D014481:United States; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*