Mental Health and Service Utilization Among Reserve and National Guard Forces

描述（由申请人提供）：这项工作的目的是在一个多变量因果框架内评估预备役和国民警卫队代表性样本的心理健康和心理健康服务利用情况，该框架考虑了生命历程经历和环境以及战斗历史、其他预备役和国民警卫队经历（例如人道主义活动）和平民创伤事件经历作为这一群体心理健康的决定因素。特别是，我们在这里不仅关注记录这些部队中精神疾病和卫生服务利用的患病率及其相关性，还关注记录这些部队中心理健康和福祉随时间的轨迹。尽管关于现役军人的心理健康和心理健康需求的文献越来越多，但据我们所知，这将是第一个明确关注预备役和国民警卫队经历的研究。考虑到在伊拉克和阿富汗反恐战争中越来越依赖预备役和国民警卫队，这一点尤为重要。目前作为“持久自由行动”（OEF）或“伊拉克自由行动”（OIF）的一部分部署到这两个国家之一，增加了美国预备役和国民警卫队成员的职责，包括经常作为应对自然灾害的一部分部署。例如，在应对卡特里娜飓风期间，军方部署了72,000名部队，其中包括50,000名国民警卫队以及海军舰艇和直升机。在本研究中，我们建议记录国民警卫队的心理病理、健康风险行为和心理健康服务利用，并确定个人因素（如社会人口因素、社会支持）、预备役和国民警卫队的参与（如服役时间长短、单位凝聚力、训练程度、军衔、与家人/亲人的分离）和生活环境(如：当考虑到战斗暴露（例如，国际部署，现役战斗）和其他创伤性事件经历时，这些因素与预备役和国民警卫队的阶段-顺序心理发病率和国民警卫队的心理发病率轨迹有关。本研究对创伤性事件暴露后的早期干预（包括战斗经历和国内部署）、国民警卫队和预备役的训练以及指挥官和军事领导的教育具有启示意义。在典型的一年里，美国军队，包括许多预备役和国民警卫队成员，部署在全球100多个国家。在伊拉克和阿富汗的反恐战争中，对预备役和国民警卫队的依赖越来越大。这项工作的目的是评估预备役人员和国民警卫队代表性样本的长期心理健康和心理健康服务利用情况，同时考虑到生命历程经历和环境，以及战斗历史、其他预备役人员和国民警卫队经历（如人道主义活动）和平民创伤事件经历作为这一群体心理健康的决定因素。本研究有助于指导创伤性事件暴露后（包括战斗经历和国内部署）早期干预的发展，军事人员的培训，以及指挥官和军事领导关于如何提高预备役和国民警卫队部队的弹性的教育。

DESCRIPTION (provided by applicant): The purpose of this work is to assess mental health and mental health service utilization over time among a representative sample of Reserves and National Guard within a multivariate causal framework that takes into account life course experiences and circumstances together with combat history, other Reserve and National Guard experience (e.g. humanitarian activity) and civilian traumatic event experiences as determinants of mental health in this group. In particular we focus here not only on documenting the prevalence and correlates of mental illness and health service utilization among these forces, but also on documenting the trajectories of mental health and well- being over time among these forces. Although there is a growing literature about the mental health and mental health needs of active duty military personnel, this would be the first study, as best we know, that has focused explicitly on the experience of the Reserve and National Guard. This is particularly important given the growing reliance on Reserve and National Guard forces during the war against terrorism in Iraq and Afghanistan. Current deployment to one of these two countries as parts of Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF) have added to the duties of members of the Reserve and National Guard forces in the US, including frequently deployment as part of the response to natural disasters. For example, during the response to Hurricane Katrina, the military deployed 72,000 forces including 50,000 National Guard as well as Navy ships and helicopters. In this study we propose to document psychopathology, health risk behavior, and mental health service utilization among National Guard and to identify personal factors (e.g., sociodemographic factors, social supports), Reserve and National Guard involvement (e.g., length of time in service, unit cohesion, extent of training, rank, separation from family/loved ones), and life circumstances (e.g., integration of regular work circumstances) that are associated with both stage- sequential psychological morbidity and trajectories of psychological morbidity over time among Reserve and National Guards when accounting for combat exposures (e.g., international deployment, active duty combat) and other traumatic event experiences. This study has implications for early intervention after exposure to traumatic events (including combat experiences and domestic deployment), training of National Guards and Reserves, and education of commanding officers and military leadership. In a typical year, US military forces, including many members of the Reserve and National Guard, are deployed in over 100 countries around the world. The reliance on Reserve and National Guard forces has become ever greater during the war against terrorism in Iraq and Afghanistan. The purpose of this work is to assess mental health and mental health service utilization over time among a representative sample of Reserves and National Guard that takes into account life course experiences and circumstances together with combat history, other Reserve and National Guard experience (e.g. humanitarian activity), and civilian traumatic event experiences as determinants of mental health in this group. This study can help guide the development of early intervention after exposure to traumatic events (including combat experiences and domestic deployment), training of military personnel, and education of commanding officers and military leadership about ways to improve resilience among Reserve and National Guard forces.