National Meeting 2009

1068 — A Preliminary Look at Perceived Mental Health Treatment Needs in a National Sample of Veterans with PTSD

Spoont MR (CCDOR; University of Minnesota) , Sayer NA (CCDOR; University of Minnesota), Murdoch M (CCDOR; University of Minnesota), Rector TS (CCDOR; University of Minnesota), Westermeyer J (CCDOR; University of Minnesota)

Objectives:
As the number of veterans with posttraumatic symptomatology increases, there has been a growing interest in the quality and type of PTSD treatment in the VA. VA/DoD guidelines recommend antidepressants and exposure therapy as first line treatments; however, there is no available information about whether these interventions match treatment needs as perceived by veterans. The current study examines perceived treatment needs among veterans recently diagnosed with PTSD.

Methods:
Information from the first 934 respondents to a large national survey was used. Subjects were those veterans diagnosed with PTSD by a VA clinician who had no VA mental health care in the year prior to diagnosis. In addition to tabulating veterans’ perceived treatment needs, logistic regression was used to determine the association of veteran race, ethnicity, age, education, gender, trauma type, period of service, symptom severity, and family encouragement to seek care on the likelihood of perceiving a need for specific kinds of help.

Results:
Most veterans (95%; n = 885) diagnosed with PTSD indicated the need for some form of help. Two-thirds (n = 689) endorsed a need for some type of psychotherapy; whereas half (52%; n = 478) reported a need for medication. Only a small fraction (5%; n = 93) endorsed a preference for pharmacotherapy exclusively. Although exposure therapies are being widely disseminated throughout the VA as first-line treatments for PTSD, about 40% (n = 387) did not want trauma-focused therapy. The odds of wanting trauma-focused therapy were greater for Hispanic/Latino veterans (OR = 1.69) and those who experienced sexual trauma (OR = 2.18). In contrast, the odds of perceiving a need for any mental health care was lower for Native Americans (OR = 0.44).

Implications:
Veterans with PTSD have specific ideas about what types of services they need and want. These perceived treatment needs may not be consistent with what is being offered to them, or what is being recommended by treatment guidelines.

Impacts:
To improve patient-centeredness of care for veterans with PTSD, it will be important to ascertain patient preferences. Better matching of treatments to veterans may improve treatment engagement and, consequently, improve treatment outcomes in this often chronically ill population.