Minimally adequate mental health care and latent classes of PTSD symptoms in female Iraq and Afghanistan veterans.
Female veterans of Operations Enduring and Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) represent a growing segment of Department of Veterans Affairs (VA) health care users. A retrospective analysis used national VA medical records to identify factors associated with female OEF/OIF/OND veterans' completion of minimally adequate care (MAC) for PTSD, defined as the completion of at least nine mental health outpatient visits within a 15-week period or at least twelve consecutive weeks of medication use. The sample included female OEF/OIF/OND veterans with PTSD who initiated VA health care between 2007-2013, and were seen in outpatient mental health (N=2183). Multivariable logistic regression models examined factors associated with completing MAC for PTSD, including PTSD symptom expression (represented by latent class analysis), sociodemographic, military, clinical, and VA access factors. Within one year of initiating mental health care, 48.3% of female veterans completed MAC. Race/ethnicity, age, PTSD symptom class, additional psychiatric diagnoses, and VA primary care use were significantly associated with completion of MAC for PTSD. Results suggest that veterans presenting for PTSD treatment should be comprehensively evaluated to identify factors associated with inadequate completion of care. Treatments that are tailored to PTSD symptom class may help to address potential barriers.
San Francisco VA Medical Center, General Medicine, 4150 Clement St., San Francisco, CA 94121, USA; University of California San Francisco, School of Medicine, 500 Parnassus Avenue, San Francisco, CA 94143, USA. Electronic address: Claire.hebenstreit@va.gov.
Claire L
CL
Hebenstreit
San Francisco VA Medical Center, General Medicine, 4150 Clement St., San Francisco, CA 94121, USA.
Erin
E
Madden
San Francisco VA Medical Center, General Medicine, 4150 Clement St., San Francisco, CA 94121, USA; University of California San Francisco, School of Medicine, 500 Parnassus Avenue, San Francisco, CA 94143, USA.
Kelly H
KH
Koo
San Francisco VA Medical Center, General Medicine, 4150 Clement St., San Francisco, CA 94121, USA; University of California San Francisco, School of Medicine, 500 Parnassus Avenue, San Francisco, CA 94143, USA.
Shira
S
Maguen
D000328:Adult; D055826:Afghan Campaign 2001-; D000368:Aged; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008603:Mental Health / Q000592:standards; D008605:Mental Health Services / Q000592:standards*; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods / Q000592:standards; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs / Q000592:standards; D014728:Veterans / Q000523:psychology*; D055815:Young Adult
Posttraumatic stress disorder; Service utilization; Veterans; Women