+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan



Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan



JAMA 295(9): 1023-1032



The US military has conducted population-level screening for mental health problems among all service members returning from deployment to Afghanistan, Iraq, and other locations. To date, no systematic analysis of this program has been conducted, and studies have not assessed the impact of these deployments on mental health care utilization after deployment. To determine the relationship between combat deployment and mental health care use during the first year after return and to assess the lessons learned from the postdeployment mental health screening effort, particularly the correlation between the screening results, actual use of mental health services, and attrition from military service. Population-based descriptive study of all Army soldiers and Marines who completed the routine postdeployment health assessment between May 1, 2003, and April 30, 2004, on return from deployment to Operation Enduring Freedom in Afghanistan (n = 16,318), Operation Iraqi Freedom (n = 222,620), and other locations (n = 64,967). Health care utilization and occupational outcomes were measured for 1 year after deployment or until leaving the service if this occurred sooner. Screening positive for posttraumatic stress disorder, major depression, or other mental health problems; referral for a mental health reason; use of mental health care services after returning from deployment; and attrition from military service. The prevalence of reporting a mental health problem was 19.1% among service members returning from Iraq compared with 11.3% after returning from Afghanistan and 8.5% after returning from other locations (P<.001). Mental health problems reported on the postdeployment assessment were significantly associated with combat experiences, mental health care referral and utilization, and attrition from military service. Thirty-five percent of Iraq war veterans accessed mental health services in the year after returning home; 12% per year were diagnosed with a mental health problem. More than 50% of those referred for a mental health reason were documented to receive follow-up care although less than 10% of all service members who received mental health treatment were referred through the screening program. Combat duty in Iraq was associated with high utilization of mental health services and attrition from military service after deployment. The deployment mental health screening program provided another indicator of the mental health impact of deployment on a population level but had limited utility in predicting the level of mental health services that were needed after deployment. The high rate of using mental health services among Operation Iraqi Freedom veterans after deployment highlights challenges in ensuring that there are adequate resources to meet the mental health needs of returning veterans.

(PDF emailed within 0-6 h: $19.90)

Accession: 012298155

Download citation: RISBibTeXText

PMID: 16507803

DOI: 10.1001/jama.295.9.1023


Related references

Mental health diagnoses and utilization of VA non-mental health medical services among returning Iraq and Afghanistan veterans. Journal of General Internal Medicine 25(1): 18-24, 2010

Mental health disorders and PTSD increase non-mental health services utilization: A study of 180,324 veterans returning from Iraq and Afghanistan seen at department of veterans affairs facilities. 2008

Social disadvantage and the mental health of military personnel returning from Iraq and Afghanistan. Administration and Policy in Mental Health 35(4): 270-271, 2008

U.S. military mental health care utilization and attrition prior to the wars in Iraq and Afghanistan. Social Psychiatry and Psychiatric Epidemiology 44(6): 473-481, 2008

Deployment, Mental Health Problems, Suicidality, and Use of Mental Health Services Among Military Personnel. Military Behavioral Health 4(3): 243-250, 2016

Prevalence of mental health symptoms in Dutch military personnel returning from deployment to Afghanistan: a 2-year longitudinal analysis. European Psychiatry 30(2): 341-346, 2016

Factors affecting help seeking for mental health problems after deployment to Iraq and Afghanistan. Psychiatric Services 65(1): 98-105, 2014

Factors associated with interest in receiving help for mental health problems in combat veterans returning from deployment to Iraq. Journal of Nervous and Mental Disease 199(10): 797-801, 2011

Comparing post-deployment mental health services utilization in soldiers deployed to Balkan, Iraq and Afghanistan. Acta Psychiatrica Scandinavica 135(6): 564-572, 2017

Trauma exposure, branch of service, and physical injury in relation to mental health among U.S. veterans returning from Iraq and Afghanistan. Military Medicine 174(8): 773-778, 2010

Association between mental health conditions diagnosed during initial eligibility for military health care benefits and subsequent deployment, attrition, and death by suicide among active duty service members. Military Medicine 177(10): 1149-1156, 2012

VA mental health services utilization in Iraq and Afghanistan veterans in the first year of receiving new mental health diagnoses. Journal of Traumatic Stress 23(1): 5-16, 2010

Prevalence of mental health problems, treatment need, and barriers to care among primary care-seeking spouses of military service members involved in Iraq and Afghanistan deployments. Military Medicine 173(11): 1051-1056, 2008

Norwegian male military veterans show low levels of mental health problems four years after deployment in Afghanistan. Nordic Journal of Psychiatry 71(1): 26-32, 2016

Prevalence of mental health problems among Iraq and Afghanistan veterans who have and have not received VA services. Psychiatric Services 65(6): 833-835, 2015