title: Occupational functioning and employment services use among VA primary care patients with posttraumatic stress disorder.
abstract: OBJECTIVE
  Veterans with posttraumatic stress disorder (PTSD) exhibit high levels of unemployment. The Department of Veterans Affairs' Veterans Health Administration (VHA) offers a variety of employment services; however, few veterans with PTSD use these services. Because many veterans with mental health conditions are seen in primary care clinics, employment service needs may be best addressed in this setting. The current study was designed to assess employment status and support needs in VHA primary care patients who screen positive for PTSD.
  
  
  METHODS
  In the study, 287 working-age VHA patients with recent primary care use completed web-based surveys that assessed employment status, PTSD symptoms, employment support preferences, and barriers to service usage.
  
  
  RESULTS
  Individuals who screened positive for PTSD were less likely to be employed than were those without PTSD (55% vs. 69%; p = .03). After adjusting for sociodemographic characteristics, individuals with PTSD had higher barriers to employment (β = 3.52, p < .001) and higher barriers to employment service use (β = 0.57, p = .02). Only 14% of those with PTSD had used VHA employment services, but 86% said they would use those services.
  
  
  CONCLUSIONS
  Although the single site included in the study may not be representative of all VHA primary care clinics, our results suggest that there is high need for and substantial interest in VHA employment services among VHA patients with PTSD. Future work should focus on implementing employment support services for individuals with PTSD in primary care settings. (PsycINFO Database Record
authors.affiliation: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System.
authors.forename: Rebecca K
authors.initials: RK
authors.lastname: Sripada
authors.affiliation: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Henry
authors.affiliation: Department of Psychiatry, University of Michigan.
authors.forename: Matheos
authors.initials: M
authors.lastname: Yosef
authors.affiliation: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System.
authors.forename: Debra S
authors.initials: DS
authors.lastname: Levine
authors.affiliation: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System.
authors.forename: Kipling M
authors.initials: KM
authors.lastname: Bohnert
authors.affiliation: Department of Psychiatry, University of Michigan.
authors.forename: Erin
authors.initials: E
authors.lastname: Miller
authors.affiliation: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System.
authors.forename: Kara
authors.initials: K
authors.lastname: Zivin
mesh_terms: D000293:Adolescent; D000328:Adult; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D014481:United States; D014493:United States Department of Veterans Affairs; D055815:Young Adult