Health Services Research & Development

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2007 HSR&D National Meeting Abstract

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National Meeting 2007

1065 — Post-Deployment Assessment of Mental Health Needs and Barriers in OIF National Guard Soldiers

Stecker T (CAVHS) , Fortney J (CAVHS)

Objectives:
Many veterans return from combat experiencing a variety of mental health concerns. Previous research has documented a stigma associated with seeking treatment that interferes with the decision to seek treatment for these concerns in the veteran population. This study was designed to assess beliefs about mental health treatment among a group of newly returning National Guard soldiers who served in the war in Iraq.

Methods:
Participants were VA-eligible OIF National Guard soldiers from the 39th Brigade in Arkansas. Eligible participants were asked to complete a structured diagnostic assessment for Major Depressive Disorder, PTSD, Generalized Anxiety Disorder, Panic Disorder and Substance Use Disorder by completing the MINI. The first twenty participants who screened positive were asked to participate in an hour long qualitative interview. During the interview, participants were asked about the advantages and disadvantages to seeking mental health treatment, who would or would not support treatment seeking, and what facilitators and barriers were in place regarding treatment seeking.

Results:
Themes emerged regarding beliefs about treatment seeking. Stigma was portrayed as a major disadvantage to treatment seeking generally (being labeled as crazy) and specifically (decisions about military promotions and operations). Meanwhile, reducing symptom expression (in relationships, feeling the same as before deployment) were major advantages of care. The majority of participants indicated that people (military, friends, family) would be supportive of treatment seeking. Barriers, however, especially those viewed as “self-induced” such as pride, not being able to ask for help, and not being able to admit to a problem, were considered major impediments to treatment seeking in this population.

Implications:
Individuals who served in the war in Iraq have considered the emotional consequences of war and are willing to engage in dialogue regarding these consequences. Mental health treatment was perceived in both positive and negative ways and individual beliefs impacted the decision to seek treatment.

Impacts:
The findings suggest that interventions developed to engage veterans into care must be directed toward contextual and cognitive factors that motivate treatment seeking, particularly in primary care settings where many veterans seek care.