title: Are Iraq and Afghanistan veterans using mental health services? New data from a national random-sample survey.
abstract: OBJECTIVE
  This study analyzed data from a national survey of Iraq and Afghanistan veterans to improve understanding of mental health services use and perceived barriers.
  
  
  METHODS
  The National Post-Deployment Adjustment Survey randomly sampled post-9/11 veterans separated from active duty or in the Reserves or National Guard. The corrected response rate was 56% (N=1,388).
  
  
  RESULTS
  Forty-three percent screened positive for posttraumatic stress disorder (PTSD), major depression, or alcohol misuse. Past-year psychiatric treatment was reported by 69% of the PTSD group, 67% of the depression group, and 45% of those with alcohol misuse. Most received care at Veterans Affairs (VA) facilities, although women were more likely than men to seek non-VA services. Veterans with more severe symptoms reported greater treatment utilization. Eighteen percent saw a pastoral counselor (chaplain) in the past year. Veterans with mental health needs who did not access treatment were more likely to believe that they had to solve problems themselves and that medications would not help. Those who had accessed treatment were more likely to express concern about being seen as weak by others.
  
  
  CONCLUSIONS
  Veterans in greatest need were more likely to access services. More than two-thirds with probable PTSD obtained past-year treatment, mostly at VA facilities. Treatment for veterans may be improved by increasing awareness of gender differences, integrating mental health and pastoral services, and recognizing that alcohol misuse may reduce utilization. Veterans who had and had not used services endorsed different perceptions about treatment, indicating that barriers to accessing care may be distinct from barriers to engaging in care.
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, CB 7167, Durham, NC 27599, USA. eric.elbogen@unc.edu
authors.forename: Eric B
authors.initials: EB
authors.lastname: Elbogen
authors.forename: H Ryan
authors.initials: HR
authors.lastname: Wagner
authors.forename: Sally C
authors.initials: SC
authors.lastname: Johnson
authors.forename: Patricia
authors.initials: P
authors.lastname: Kinneer
authors.forename: Han
authors.initials: H
authors.lastname: Kang
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Vasterling
authors.forename: Christine
authors.initials: C
authors.lastname: Timko
authors.forename: Jean C
authors.initials: JC
authors.lastname: Beckham
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D005260:Female; D006306:Health Surveys; D006801:Humans; D054542:Iraq War, 2003-2011; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D017678:Sex Distribution; D057545:Social Stigma; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*