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HSR&D 2004 National Meeting Abstracts

2064. Factors Associated With Mental Health Treatment for Veterans
Dorcas L Mansell, MD, MPH, Birmingham VAMC TREP, D Saunders, Birmingham VAMC TREP, L Kazis, CHQOER, Bedford VAMC, DR Miller, CHQOER, Bedford VAMC

Objectives: Mental health problems occur frequently in ambulatory care populations but are often under-treated. We examined whether patient factors and reported access to care were associated with mental health treatment in patients with depression, PTSD, and alcohol problems.

Methods: Patients in the Veterans Health Study were assessed for depression (CESD score > 16), PTSD (traumatic event and PCL-C score >42), and alcohol problems (CAGE >=2 and past year drink). For patients with at least one mental health condition, use of past 3 month mental health treatment was modeled as the dependent variable in a logistic regression model with age (in years), marital status, education, race, service connected status, and perceived access as independent variables.

Results: 921 of 2425 (37.9%) patients had at least one mental health problem. 16.8% reported mental health treatment in the past 3 months. Mean age was 65.0, 61.4% married, 76.2 % >= a high school education, 59.2% service connected, 4.1% African American. Older patients (OR 0.95, 0.94 to 0.97), married patients (OR 0.64, 0.42 to 0.97), African American patients (OR 0.13, 0.02 to 1.005) were less likely to report treatment; service connected patients were more likely to report treatment (OR 1.8, 1.2 to 2.8) with c=0.707.

Conclusions: Elderly, married, and African American patients with mental health problems were less likely to receive care. Reported access to care was not associated with lack of mental health treatment.

Impact: Interventions to increase use of mental health treatment may include targeting to elderly, married, and African American patients.