Predictors of mental health care use among male and female veterans deployed in support of the wars in Afghanistan and Iraq.

What factors predict whether Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans who need mental health care receive that care? The present research examined factors associated with a need for care, sociodemographic characteristics, deployment experiences, and perceptions of care as gender-specific predictors of overall mental health care use and Veterans Affairs (VA) mental health care use for male and female OEF/OIF veterans (N = 1,040). Only veterans with a probable need for mental health care, as determined by scores on self-report measures of mental health symptomatology, were included in the sample. Overall, predictors of service use were similar for women and men. A notable exception was the finding that lower income predicted use of both overall and VA mental health care for women, but not men. In addition, sexual harassment was a unique predictor of VA service use for women, whereas non-White race was predictive of VA service use for men only. Knowledge regarding the factors that are associated with use of mental health care (broadly and at VA) is critical to ensuring that veterans who need mental health care receive it.

[1]  Mark R Schultz,et al.  Predeployment, deployment, and postdeployment risk factors for posttraumatic stress symptomatology in female and male OEF/OIF veterans. , 2011, Journal of abnormal psychology.

[2]  Shannon M. Kehle,et al.  Early mental health treatment-seeking among U.S. National Guard soldiers deployed to Iraq. , 2010, Journal of traumatic stress.

[3]  A. Rosen,et al.  Gender differences in veterans health administration mental health service use: effects of age and psychiatric diagnosis. , 2009, Women's health issues : official publication of the Jacobs Institute of Women's Health.

[4]  D. Gleaves,et al.  Patterns and predictors of mental health service use and mental illness among older and younger adults in the United States. , 2008 .

[5]  L. King,et al.  Toward Gender-aware Health Care , 2008, Journal of health psychology.

[6]  D. King,et al.  Validation of Scales From the Deployment Risk and Resilience Inventory in a Sample of Operation Iraqi Freedom Veterans , 2008, Assessment.

[7]  Terri Tanielian,et al.  Invisible Wounds of War. Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery , 2008 .

[8]  J. Daley,et al.  Effects of Military Trauma Exposure on Women Veterans’ Use and Perceptions of Veterans Health Administration Care , 2008, Journal of General Internal Medicine.

[9]  S. Guay,et al.  Twelve Month Use of Mental Health Services in a Nationally Representative, Active Military Sample , 2008, Medical care.

[10]  Besa Smith,et al.  Meets the Internet : Web-based Surveys in the Millennium Cohort Study , 2007 .

[11]  D. Vogt,et al.  Risk and resilience factors for posttraumatic stress symptomatology in Gulf War I veterans. , 2007, Journal of traumatic stress.

[12]  J. Daley,et al.  Barriers to veterans health administration care in a nationally representative sample of women veterans , 2006, Journal of General Internal Medicine.

[13]  Charles W Hoge,et al.  Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. , 2006, JAMA.

[14]  E. Yano,et al.  To use or not to use , 2006, Journal of General Internal Medicine.

[15]  Jeffrey Knight,et al.  Deployment Risk and Resilience Inventory: A Collection of Measures for Studying Deployment-Related Experiences of Military Personnel and Veterans , 2006 .

[16]  C. Hoge,et al.  THE NEW ENGLAND JOURNAL OF MEDICINE , 1977, The Lancet.

[17]  J. Daley,et al.  Use of VA Health Care Services by Women Veterans: Findings from a National Sample , 2003, Women & health.

[18]  Lynda A. King,et al.  Gender Awareness Among Veterans Administration Health-Care Workers: Existing Strengths and Areas for Improvement , 2001, Women & health.

[19]  D. Kivlahan,et al.  Variations on the CAGE alcohol screening questionnaire: strengths and limitations in VA general medical patients. , 2001, Alcoholism, clinical and experimental research.

[20]  C. Muntaner,et al.  Racial differences in attitudes toward professional mental health care and in the use of services. , 2000, The American journal of orthopsychiatry.

[21]  N. Kressin,et al.  Patient satisfaction with Department of Veterans Affairs health care: do women differ from men? , 1999, Military medicine.

[22]  R. Rosenheck,et al.  Female veterans' use of Department of Veterans Affairs health care services. , 1998, Medical care.

[23]  R. Kessler,et al.  The use of outpatient mental health services in the United States and Ontario: the impact of mental morbidity and perceived need for care. , 1997, American journal of public health.

[24]  D L Patrick,et al.  Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). , 1994, American journal of preventive medicine.

[25]  R. Rosenheck,et al.  Wartime military service and utilization of VA health care services. , 1993, Military medicine.

[26]  R. Centor,et al.  Screening for alcohol abuse using CAGE scores and likelihood ratios. , 1991, Annals of internal medicine.

[27]  J. Romeis,et al.  Female Veterans' Use of Health Care Services , 1988, Medical care.

[28]  J. Ewing,et al.  Detecting alcoholism. The CAGE questionnaire. , 1984, JAMA.

[29]  L. Radloff The CES-D Scale , 1977 .

[30]  Terry L. Schell,et al.  A Needs Assessment of New York State Veterans: Final Report to the New York State Health Foundation. , 2011, Rand health quarterly.

[31]  M. Addis,et al.  Men, masculinity, and the contexts of help seeking. , 2003, The American psychologist.

[32]  Dc Washington Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .