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2015 HSR&D/QUERI National Conference Abstract

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3106 — The Relationship between Mental Health Stigma and Physical Health in OEF/OIF Veterans

Fox-Galalis AB, Women's Health Sciences Division, National Center for PTSD; VA Boston HCS; Vogt DS, Women's Health Sciences Division, National Center for PTSD; VA Boston HCS; Department of Psychiatry, Boston University School of Medicine; Smith BN, Women's Health Sciences Division of the National Center for PTSD; VA Boston HCS; Department of Psychiatry, Boston University;

Objectives:
A substantial body of research has demonstrated that mental health stigma is associated with increased symptomology and decreased mental health treatment seeking in both civilian and Veteran samples. However, mental illness stigma may also impact Veteran's physical health. Concerns about stigmatization may serve as a chronic stressor that increases an individual's risk for developing physical health problems, and/or prevents individuals from seeking necessary care for co-morbid medical conditions. In the present study, we examined the relationships between mental illness stigma, physical health, and treatment seeking for co-morbid physical health conditions among OEF/OIF Veterans.

Methods:
Data were collected as part of an HSRandD funded survey of OEF/OIF Veterans. The current sample was limited to participants with probable mental health condition (N = 278). Participants reported the number and types of physical health conditions for which they had a diagnosis both before and after deployment, their use of VA health services in the past six months, and a comprehensive measure of mental illness stigma. We used linear regression to examine the relationship between stigma and physical health (controlling for age and pre-deployment health), and then used logistic regression to predict VA healthcare use. Analyses were gender stratified to allow for comparisons between women and men.

Results:
For women, concerns about stigma from friends and family were associated with increased post-deployment physical health problems (Beta = .25, p = .02). Additionally, negative beliefs about mental illness were associated with decreased likelihood of using VA healthcare (OR = .92). For men, although there was no relationship between stigma and number of post-deployment physical health, negative beliefs about mental illness (OR = .90) and concerns about stigma in the workplace (OR = .88) were associated with decreased use of VA medical services, while concerns about stigma from family and friends was associated with increased use of VA care (OR = 1.22).

Implications:
The harmful effects of mental illness stigma appear to extend beyond their impact on mental health to potentially impact veteran's physical health and treatment seeking.

Impacts:
Results underscore the importance of ongoing efforts to decrease mental illness stigma among Veterans.