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Health Services Research & Development

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2015 HSR&D/QUERI National Conference Abstract

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1004 — Increasing Treatment-Seeking among at-Risk Service Members Returning Veterans from War Zones

Stecker T, White River Junction VA;

Objectives:
Reducing suicide is a national priority and an urgent concern within the Department of Defense and the Department of Veterans Affairs. Rates of suicide among active duty service members have increased dramatically since 2005. Although many service members experience mental health concerns, they do not necessarily seek services to treat their symptoms. The purpose of this study was to test the effectiveness of a brief cognitive-behavioral intervention designed to modify beliefs about treatment so that service members at-risk for suicide are more likely to seek treatment.

Methods:
We are in year 2 of this 6-year RCT of 1,200 military service members who are at increased risk for suicide but not currently in mental health treatment. To be eligible, participants must be serving in the U.S. military or served after September 11th, 2001; screen positive for suicidal ideation as indicated by the PHQ9, and not be receiving any mental health treatment. Participants are assessed for symptoms and are asked about their perceptions of mental health treatment. Participants are randomly assigned to either the intervention or control group. Intervention participants are administered a one-hour cognitive-behavioral session delivered by phone during which they were asked to discuss beliefs about treatment. All participants are reassessed on symptoms and treatment utilization at 1, 3, 6, and 12 month interviews.

Results:
Of the 486 participants enrolled in this trial, 244 are in the intervention condition and 242 in the control condition. Demographic characteristics at baseline are male (90%); Caucasian (65%) and a mean age of 31. Both groups report moderate symptoms of PTSD and depression at baseline (Intervention PCL = 62.5, PHQ-9 = 18.1; Control PCL = 62.4, PHQ-9 = 18.6). Although preliminary, early results suggest that intervention participants (14%) are more likely to attend a mental health appointment post-intervention than participants in the control group (7%).

Implications:
A brief cognitive-behavioral intervention to increase mental health treatment seeking among at-risk service members holds promise.

Impacts:
This intervention could be easily implemented within primary care at the VHA and the DoD, and through the VA's National Crisis Line and help save lives among those not yet in the VA system.