Determinants of prospective engagement in mental health treatment among symptomatic Iraq/Afghanistan veterans.
There is considerable public and professional concern about the mental health status of veterans deployed to Iraq and Afghanistan as well as how to engage and retain symptomatic veterans in treatment. This study examined demographic, psychiatric, and psychosocial determinants of prospective initiation and retention in mental health services among symptomatic Iraq/Afghanistan veterans. One hundred thirty-seven symptomatic veterans who were referred to mental health screening completed a survey at the time of their first mental health visit. Associations between survey variables and subsequent Veterans Affairs service utilization were evaluated. The most consistent determinants of mental health service initiation and retention were severity of posttraumatic stress disorder (PTSD) and depressive symptoms. Notably, whereas PTSD-related re-experiencing symptoms were independently associated with initiation of mental health treatment, PTSD-related numbing symptoms were independently associated with retention in treatment. Stigma, barriers to care, and beliefs about mental health treatment were not associated with either mental health initiation or retention.
*Department of Psychiatry, Yale University School of Medicine, New Haven, CT; †Clinical Neurosciences Division, National Center for Posttraumatic Stress Disorder, West Haven, CT; and ‡VA New England Mental Illness, Research, Education and Clinical Center, West Haven, CT.
Ilan
I
Harpaz-Rotem
Robert A
RA
Rosenheck
Robert H
RH
Pietrzak
Steven M
SM
Southwick
D000328:Adult; D055826:Afghan Campaign 2001-; D003863:Depression / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D005260:Female; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data; D058014:Veterans Health / Q000706:statistics & numerical data*; D055815:Young Adult