title: Mental Health Treatment for Older Veterans Newly Diagnosed with PTSD: A National Investigation.
abstract: OBJECTIVE
  Older veterans are the largest cohort served by the U.S. Department of Veterans Affairs (VA). The aim of this study was to examine mental health service utilization among older veterans recently diagnosed with posttraumatic stress disorder (PTSD), with an interest in sociodemographic and clinical characteristics related to receipt and type of mental health treatment.
  
  
  METHODS
  VA National administrative data set and pharmacy records.
  
  
  METHODS
  VA Healthcare System.
  
  
  METHODS
  The sample comprised 96,249 veterans aged 50+ years who received a new diagnosis of PTSD between fiscal years 2008-2011.
  
  
  METHODS
  Demographic/clinical characteristics and treatment variables (receipt of mental health treatment; number of days before first appointment; receipt of psychotherapy, medication, or combination treatment; type of medication; number of psychotherapy visits) were assessed and relations were examined using logistic, negative binomial, and Cox regressions.
  
  
  RESULTS
  The majority of older veterans with newly diagnosed PTSD received at least one follow-up mental health visit. Increasing age was associated with decreased odds of receipt of any type of mental health treatment, and psychiatric comorbidities and greater number of medical appointments were associated with increased odds of treatment. Among veterans who received treatment, increased age was associated with decreased odds of receiving both psychotherapy and pharmacotherapy, decreased number of psychotherapy visits, and increased waiting times.
  
  
  CONCLUSIONS
  Among older veterans recently diagnosed with PTSD in the VA healthcare system, older individuals, particularly those over 80 years old, are at risk of not receiving timely and appropriate mental health treatment, indicating targeted outreach to this population could be helpful in improving care.
authors.affiliation: National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT; Department of Psychiatry, Yale School of Medicine, New Haven, CT. Electronic address: Noelle.smith@yale.edu.
authors.forename: Noelle B
authors.initials: NB
authors.lastname: Smith
authors.affiliation: National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT; Department of Psychiatry, Yale School of Medicine, New Haven, CT.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Cook
authors.affiliation: National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT; Department of Psychiatry, Yale School of Medicine, New Haven, CT.
authors.forename: Robert
authors.initials: R
authors.lastname: Pietrzak
authors.affiliation: National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT; Department of Psychiatry, Yale School of Medicine, New Haven, CT; VA Northeast Program Evaluation Center.
authors.forename: Rani
authors.initials: R
authors.lastname: Hoff
authors.affiliation: National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT; Department of Psychiatry, Yale School of Medicine, New Haven, CT; VA Northeast Program Evaluation Center.
authors.forename: Ilan
authors.initials: I
authors.lastname: Harpaz-Rotem
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D015897:Comorbidity; D016208:Databases, Factual; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011613:Psychotherapy / Q000706:statistics & numerical data; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*
keywords: Older adult veterans; medication; mental health treatment; posttraumatic stress disorder; psychotherapy