3055 — Barriers and Facilitators to PTSD Treatment Seeking Among OIF/OEF and Vietnam Veterans

Sayer NA (COE Minneapolis), Friedemann-Sanchez G (University MN), Spoont M (COE Minneapolis), Chiros C (Minneapolis VAMC), Parker L (Independent Consultant)

Objectives:
1. To identify barriers and facilitators to treatment seeking for Posttraumatic Stress Disorder (PTSD) among OIF/OEF and Vietnam combat veterans after problem recognition; 2. To determine whether barriers and facilitators differ by service era (OIF/OEF, Vietnam) and by treatment seeking status (yes, no).

Methods:
We conducted 44 semi-structured qualitative interviews concerning veterans’ experiences getting professional help for PTSD. Participants were 30 male and 14 female OIF/OEF and Vietnam veterans recruited from those applying for PTSD service connection through a large Midwestern VBA Regional Office. All but three were white; ages ranged from 20 to 62 years (M = 42.11, SD = 15.99). We audio-recorded interviews and conducted content analysis of verbatim transcripts.

Results:
Barriers included insufficient knowledge about PTSD and confusion about eligibility for VA services, trauma-related emotions, pride in self-reliance, misconceptions about treatment, stigma, mismatches between preferences and available services, and access difficulties (e.g. distance to facility, work schedule). Vietnam veterans and victims of military sexual trauma, but not male OIF/OEF veterans, also described lack of societal, institutional and interpersonal support post-trauma and/or post-deployment as deterring them from seeking help for PTSD. Facilitators included symptom recognition and severity, readiness to change, motivation to improve quality of life, social support, institutional and societal acceptance of PTSD, technology, including telemedicine and the internet, and screening programs. Treatment-seeking Vietnam veterans described regret for not having sought mental health treatment sooner.

Implications:
Veterans described individual, social, societal and health care system level barriers and facilitators to seeking treatment for PTSD. Societal changes and age may account for some of the differences across groups. Educational programs to reduce confusion about PTSD and VA eligibility and to dispel treatment misconceptions should facilitate treatment seeking. Interventions and outreach strategies that encourage self-reliance, reduce stigma and make use of the internet and telemedicine are likely to be acceptable to veterans.

Impacts:
Findings have implications for the development of outreach strategies, PTSD services and educational initiatives to promote treatment seeking before PTSD becomes chronic and disabling. VA may need to tailor outreach strategies for veterans who experienced lack of support post-trauma or post-deployment, such as Vietnam veterans and those with MST histories.