Are Iraq and Afghanistan Veterans Using Mental Health Services? New Data From a National Random-Sample Survey
Are Iraq and Afghanistan Veterans Using Mental Health Services? New Data From a National Random-Sample Survey
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DOI：
10.1176/appi.ps.004792011
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发表时间：
2013-02-01
影响因子：
3.8
通讯作者：
Beckham, Jean C.
中科院分区：
文献类型：
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作者：
Elbogen, Eric B.;Wagner, H. Ryan;Beckham, Jean C.
目的：这项研究分析了伊拉克和阿富汗退伍军人的全国调查数据，以提高对心理健康服务使用和感知障碍的理解。研究方法：国家部署后调整调查随机抽样后9/11退伍军人从现役或在预备役或国民警卫队分离。校正应答率为56%（N= 1，388）。结果：43%的人在创伤后应激障碍（PTSD）、重度抑郁症或酒精滥用方面呈阳性。69%的PTSD组、67%的抑郁症组和45%的酒精滥用者报告了过去一年的精神治疗。大多数人在退伍军人事务部（VA）设施接受护理，尽管妇女比男子更有可能寻求非VA服务。症状更严重的退伍军人报告了更大的治疗利用率。18%的人在过去的一年里看过牧师顾问（牧师）。有心理健康需求但没有获得治疗的退伍军人更有可能认为他们必须自己解决问题，而药物无济于事。那些接受过治疗的人更有可能对被他人视为弱者表示担忧。结论：最需要的退伍军人更有可能获得服务。超过三分之二的可能患有PTSD的人在过去一年中接受了治疗，主要是在VA设施。通过提高对性别差异的认识，整合心理健康和牧师服务，以及认识到酒精滥用可能会减少使用，退伍军人的治疗可能会得到改善。退伍军人谁和没有使用的服务赞同不同的看法治疗，这表明，获得护理的障碍可能是不同的障碍，从事护理。
Objective: This study analyzed data from a national survey of Iraq and Afghanistan veterans to improve understanding of mental health services use and perceived barriers. Methods: The National Post-Deployment Adjustment Survey randomly sampled post-9/11 veterans separated from active duty or in the Reserves or National Guard. The corrected response rate was 56% (N=1,388). Results: Forty-three percent screened positive for posttraumatic stress disorder (PTSD), major depression, or alcohol misuse. Past-year psychiatric treatment was reported by 69% of the PTSD group, 67% of the depression group, and 45% of those with alcohol misuse. Most received care at Veterans Affairs (VA) facilities, although women were more likely than men to seek non-VA services. Veterans with more severe symptoms reported greater treatment utilization. Eighteen percent saw a pastoral counselor (chaplain) in the past year. Veterans with mental health needs who did not access treatment were more likely to believe that they had to solve problems themselves and that medications would not help. Those who had accessed treatment were more likely to express concern about being seen as weak by others. Conclusions: Veterans in greatest need were more likely to access services. More than two-thirds with probable PTSD obtained past-year treatment, mostly at VA facilities. Treatment for veterans may be improved by increasing awareness of gender differences, integrating mental health and pastoral services, and recognizing that alcohol misuse may reduce utilization. Veterans who had and had not used services endorsed different perceptions about treatment, indicating that barriers to accessing care may be distinct from barriers to engaging in care.