2011 National Meeting

1056 — OEF/OIF Reserve and National Guard Women Veteran Barriers to Mental Healthcare: Deployment and Provider Effects

Mengeling MA (CRIISP & Midwest RHC, Iowa City VAMC & University of Iowa) , Booth BM (CEMHOR COE & University of Arkansas for Medical Sciences), Torner J (University of Iowa School of Public Health), Sadler AG (CRIISP, Iowa City VAMC)

Objectives:
Determine if deployment status is associated with greater self-reported barriers to mental health (MH) care.

Methods:
665 women participated in a cross-sectional study of current health, health risk behaviors, and care utilization. OEF/OIF-era Reserve and National Guard (R/NG) women Veterans were sampled from five Midwestern states and stratified by deployment (never deployed, deployed to Iraq or Afghanistan, deployed elsewhere).

Results:
Deployed participants (n = 521) were more likely to believe MH prescriptions could interfere with their job performance (48% v 35%; OR = 1.41 (1.00-1.99)); to know where to receive counseling while in the R/NG (87% v 74%; OR = 2.33, 1.49-3.66); and to believe their unit wouldn’t lose confidence in them if they sought MH care (49% v 38%; OR 1.36, .96–1.92) relative to non-deployed peers. Those deployed to Iraq/Afghanistan were less-likely to believe that seeking MH care treatment would harm their career than those deployed elsewhere (32% v 41%; OR = .61, .43-.86). Half of women deployed to Iraq/Afghanistan had concerns their MH care would not remain confidential while deployed. Almost half (47.1%) said they would informally talk with an off-duty healthcare provider if they had a physical or MH concern during deployment. Those who believed their care would not remain confidential were more likely to endorse presenting a physical complaint to see a provider in order to bring up MH concerns (50% v 35%; p < .01).

Implications:
Deployed R/NG personnel reported knowing where to seek MH care and were less concerned about unit reaction than their non-deployed counterparts. However, they were less likely to seek care because of concerns about prescription effects on job performance. Those deployed to Iraq/Afghanistan reported that they would present with a physical health complaint in order to seek MH care. Seeking physical and mental healthcare from off-duty providers was another care seeking method of deployed personnel.

Impacts:
R/NG servicewomen who have been deployed (compared to those who haven’t) report unique barriers and facilitators to MH care. VA primary care clinicians must be educated that deployed R/NG servicewomen may have concerns about confidentiality and if so are acculturated to access MH care by presentation with physical complaints. Deployed healthcare providers may be a high risk population for burnout or secondary traumatization.