Postdeployment Treatment Gap: Symptoms and Treatment Utilization Among Returning National Guard Soldiers.

Simon B Goldberg, Anthony W P Flynn, Maleeha Abbas, Megan E Schultz, Michele Hiserodt, Kathryn A Thomas, Kasey Kallio, Mary F Wyman
Author Information
  1. Simon B Goldberg: University of Wisconsin-Madison.
  2. Anthony W P Flynn: University of Wisconsin-Madison.
  3. Maleeha Abbas: VA Puget Sound Health Care System, Seattle Division.
  4. Megan E Schultz: William S. Middleton Memorial Veterans Hospital.
  5. Michele Hiserodt: William S. Middleton Memorial Veterans Hospital.
  6. Kathryn A Thomas: University of Wisconsin-Madison.
  7. Kasey Kallio: William S. Middleton Memorial Veterans Hospital.
  8. Mary F Wyman: William S. Middleton Memorial Veterans Hospital.

Abstract

This study evaluated rates of psychiatric symptoms and mental health treatment utilization among National Guard service members during the post-deployment period. National Guard service members (=311) completed surveys assessing demographics, beliefs about mental health treatment, emotion regulation strategies, and psychiatric symptoms. Mental health treatment utilization was assessed at 6-month follow-up. Post-deployment, 41.2% of the sample had psychiatric symptoms above the clinical cut-off for at least one symptom measure. This proportion increased at follow-up (53.5%). Alcohol use disorder (AUD) symptoms showed the largest increase (=0.66), although symptoms of depression and posttraumatic stress disorder (PTSD) also showed small magnitude increases. Among those with elevated symptoms post-deployment (=128), only 27.8% received mental health treatment at follow-up. Severity of depression, anxiety, and PTSD were higher among those who utilized treatment. The post-deployment period is a vulnerable one. Continued efforts to understand and address barriers to treatment for this population are warranted.

Keywords

References

  1. Bull World Health Organ. 2004 Nov;82(11):858-66 [PMID: 15640922]
  2. Psychiatr Serv. 2019 May 1;70(5):358-366 [PMID: 30841842]
  3. Patient Prefer Adherence. 2010 Mar 24;4:45-9 [PMID: 20390058]
  4. Psychiatr Serv. 2011 Feb;62(2):135-42 [PMID: 21285091]
  5. Psychiatr Serv. 2010 Jun;61(6):589-97 [PMID: 20513682]
  6. Psychol Med. 2011 Aug;41(8):1751-61 [PMID: 21134315]
  7. J Fam Psychol. 2010 Oct;24(5):560-7 [PMID: 20954766]
  8. Psychiatr Serv. 2007 May;58(5):642-51 [PMID: 17463345]
  9. Arch Intern Med. 2007 Mar 12;167(5):476-82 [PMID: 17353495]
  10. Br J Psychiatry. 2011 Feb;198(2):136-42 [PMID: 21282784]
  11. JAMA. 2006 Mar 1;295(9):1023-32 [PMID: 16507803]
  12. Arch Intern Med. 2006 May 22;166(10):1092-7 [PMID: 16717171]
  13. Drug Alcohol Depend. 2011 Jul 1;116(1-3):93-101 [PMID: 21277712]
  14. Adm Policy Ment Health. 2020 Jul;47(4):555-568 [PMID: 31989399]
  15. Am J Public Health. 2012 Mar;102 Suppl 1:S29-32 [PMID: 22390596]
  16. Psychiatr Serv. 2014 Aug 1;65(8):997-1004 [PMID: 24788253]
  17. J Consult Clin Psychol. 1970 Aug;35(1):79-90 [PMID: 5487612]
  18. Arch Gen Psychiatry. 2010 Jun;67(6):614-23 [PMID: 20530011]
  19. Psychol Assess. 2019 Dec;31(12):1412-1427 [PMID: 30896212]
  20. Addiction. 2016 Oct;111(10):1786-94 [PMID: 27061707]
  21. J Fam Nurs. 2010 Feb;16(1):45-67 [PMID: 20065118]
  22. Psychol Serv. 2014 Feb;11(1):105-13 [PMID: 24274110]
  23. Arch Gen Psychiatry. 2005 Jun;62(6):603-13 [PMID: 15939838]
  24. Psychol Med. 2011 Apr;41(4):687-98 [PMID: 21144108]
  25. J Fam Psychol. 2013 Apr;27(2):303-13 [PMID: 23544925]
  26. Lancet. 2017 Apr 8;389(10077):1453-1463 [PMID: 28402827]
  27. Psychiatr Serv. 2011 Jan;62(1):28-34 [PMID: 21209296]
  28. JAMA. 2007 Nov 14;298(18):2141-8 [PMID: 18000197]
  29. Mil Behav Health. 2015;3(4):230-239 [PMID: 26664795]
  30. J Nerv Ment Dis. 2012 May;200(5):444-50 [PMID: 22551799]
  31. J Trauma Stress. 2010 Feb;23(1):33-40 [PMID: 20104591]
  32. J Stud Alcohol. 1995 Jul;56(4):423-32 [PMID: 7674678]
  33. Psychiatr Serv. 2018 Jun 1;69(6):696-702 [PMID: 29540119]
  34. NCHS Data Brief. 2015 Jun;(206):1-8 [PMID: 26079520]
  35. Psychiatr Serv. 2012 Sep 1;63(9):855-61 [PMID: 22706956]
  36. Psychiatr Serv. 2017 Jul 1;68(7):727-729 [PMID: 28245699]
  37. Psychiatr Serv. 2013 Mar 1;64(3):280-3 [PMID: 23450385]
  38. Drug Alcohol Depend. 2010 Nov 1;112(1-2):150-5 [PMID: 20656425]
  39. Psychol Serv. 2018 May;15(2):146-153 [PMID: 29723016]
  40. Arch Intern Med. 2003 Apr 14;163(7):821-9 [PMID: 12695273]
  41. N Engl J Med. 2004 Jul 1;351(1):13-22 [PMID: 15229303]
  42. Psychiatr Serv. 2009 Aug;60(8):1118-22 [PMID: 19648201]
  43. Psychol Assess. 2012 Dec;24(4):1034-40 [PMID: 22545697]
  44. Mil Med. 2014 Aug;179(8):879-84 [PMID: 25102530]
  45. Psychol Serv. 2015 Feb;12(1):49-58 [PMID: 25365245]
  46. Depress Anxiety. 2017 Jan;34(1):79-88 [PMID: 27559724]
  47. J Pers Soc Psychol. 2003 Aug;85(2):348-62 [PMID: 12916575]
  48. Ann N Y Acad Sci. 2006 Jul;1071:67-79 [PMID: 16891563]
  49. J Anxiety Disord. 2015 Apr;31:98-107 [PMID: 25768399]
  50. J Trauma Stress. 2015 Aug;28(4):289-97 [PMID: 26215254]
  51. Psychiatr Serv. 2013 Feb 1;64(2):134-41 [PMID: 23475498]
  52. Psychol Assess. 2001 Dec;13(4):503-20 [PMID: 11793894]

Grants

  1. K23 AT010879/NCCIH NIH HHS

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