Predictors of operation enduring freedom/Operation Iraqi Freedom veterans' engagement in mental health treatment

摘要

Although the prevalence of mental health disorders in troops serving in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) is high, many OEF/OIF veterans appear to refuse or delay mental health treatment. To examine psychological and psychosocial predictors of engagement, this pilot study examined eight factors: age, ethnicity, gender, polytrauma status, time since military separation, alcohol use, substance use, and psychiatric comorbidity. Structured clinical interviews given to all OEF/OIF veterans enrolling at a large Veterans Affairs health care center from 2007 to 2010 were examined, as were all psychiatric visits for the next year. Surprisingly, 72% of the sample (N = 600) was diagnosed with a psychiatric disorder. Of those (n = 429), the majority agreed to an initial mental health referral and attended at least one appointment within the year (n = 229, 53%), but only a quarter (n = 113, 26%) attended eight or more appointments. Multinomial regression analysis indicated that psychiatric comorbidity, polytrauma exposure, and time since military separation were the best predictors of initial engagement in needed mental health treatment, and psychiatric comorbidity and age were the best predictors of treatment retention. Findings suggest that Veterans Affairs may further improve engagement by attending to time since separation.