Importance of Anonymity to Encourage Honest Reporting in Mental Health Screening After Combat Deployment
Importance of Anonymity to Encourage Honest Reporting in Mental Health Screening After Combat Deployment
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DOI：
10.1001/archgenpsychiatry.2011.112
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发表时间：
2011-10-01
影响因子：
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通讯作者：
Hoge, Charles
中科院分区：
文献类型：
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作者：
Warner, Christopher H.;Appenzeller, George N.;Hoge, Charles
内容：美国士兵在伊拉克或阿富汗服役归来后，必须接受抑郁症、创伤后应激障碍（PTSD）和其他心理健康问题的筛查，这是常规的部署后健康评估的一部分。目的：评估筛查过程的匿名性对士兵在战斗部署后报告心理健康问题的意愿的影响。设计：匿名和非匿名调查。设置：美国军队。患者：美国步兵士兵的报告心理健康问题的常规部署后的健康评估进行了比较，他们的报告在一个匿名的调查administered simultaneously.Main Outcome Measures：初级保健PTSD屏幕，患者健康问卷-2（修改），自杀意念问题，从患者健康问卷-9，和其他几个问题有关的心理健康被用于这两个调查。匿名调查中还询问了士兵对耻辱的看法和诚实报告的意愿。结果：2008年，来自一个步兵旅战斗队的3502名美国陆军士兵接受了例行的部署后健康评估，共有2500人受邀完成匿名调查，其中1712人参与（回复率，68.5%）。与常规部署后健康评估相比，匿名调查中报告的抑郁症、创伤后应激障碍、自杀意念和接受护理的兴趣高出2倍至4倍。总体而言，20.3%的士兵抑郁症或创伤后应激障碍筛查阳性的报告，他们不舒服诚实地报告他们的答案在常规postdeployment screen.Conclusions：目前postdeployment心理健康筛查工具是依赖于士兵诚实地报告他们的症状。这项研究表明，部署后健康评估筛选过程错过了大多数士兵有重大的心理健康问题。需要进一步努力，减少报告精神健康问题的耻辱感，提高接受精神健康问题护理的意愿。
Context: US soldiers are required to undergo screening for depression, posttraumatic stress disorder (PTSD), and other mental health problems on return from service in Iraq or Afghanistan as part of routine postdeployment health assessments.Objective: To assess the influence of the anonymity of screening processes on willingness of soldiers to report mental health problems after combat deployment.Design: Anonymous and nonanonymous surveys.Setting: US military.Patients: US infantry soldiers' reporting of mental health problems on the routine Post-Deployment Health Assessment was compared with their reporting on an anonymous survey administered simultaneously.Main Outcome Measures: The Primary Care PTSD Screen, the Patient Health Questionnaire-2 (modified), the suicidal ideation question from the Patient Health Questionnaire-9, and several other questions related to mental health were used on both surveys. Soldiers were also asked on the anonymous survey about perceptions of stigma and willingness to report honestly.Results: Of 3502 US Army soldiers from one infantry brigade combat team undergoing the routine Post-Deployment Health Assessment in 2008, a total of 2500 were invited to complete the anonymous survey, and 1712 of these participated (response rate, 68.5%). Reporting of depression, PTSD, suicidal ideation, and interest in receiving care were 2-fold to 4-fold higher on the anonymous survey compared with the routine Post-Deployment Health Assessment. Overall, 20.3% of soldiers who screened positive for depression or PTSD reported that they were uncomfortable reporting their answers honestly on the routine postdeployment screening.Conclusions: Current postdeployment mental health screening tools are dependent on soldiers honestly reporting their symptoms. This study indicates that the Post-Deployment Health Assessment screening process misses most soldiers with significant mental health problems. Further efforts are required to reduce the stigma of reporting and improve willingness to receive care for mental health problems.