Study Examines Use of Mental Health and Non-Mental Health Outpatient Care by OEF/OIF Veterans with Military Sexual Trauma
Research shows that 15% of female OEF/OIF Veterans and 0.7% of male Veterans who received services from the VA healthcare system reported at least one incident of military sexual trauma (MST). All Veterans who screen positive for MST are eligible to receive free VA healthcare services for both mental and physical conditions related to their MST. In FY09, every VA healthcare facility provided at least one instance of MST-related care, and almost 590,000 outpatient visits were designated as MST-related. Although prior research has demonstrated the feasibility of universal screening within VA, no research has examined the characteristics of Veterans who choose to access MST-related care — or the characteristics of that care. This study examined characteristics of the use and intensity of MST-related care among 4,458 OEF/OIF Veterans in a one-year period after reporting an experience of MST. Characteristics included sociodemographics, military service factors, and primary diagnoses. Veterans were screened between 2006 and 2008, and had at least one VA outpatient encounter in the year following the positive MST screen.
Findings show that the most notable factor that influenced the receipt and intensity of MST-related care was gender. Male Veterans used less care than female Veterans and had a lower intensity of MST-related care compared to women, even after controlling for total number of healthcare visits. Other sociodemographic and military variables associated with less use and/or less intensity of MST-related care were younger age, unknown race/ethnicity, being in the Marines or Air Force, and being in the National Guard or Reserve. Among all Veterans who screened positive for MST, the majority (76%) received at least one MST-related care visit within a year of the positive screen. In examining diagnostic characteristics of MST-related care, the most common primary diagnoses related to a Veterans' MST-related care were mental health diagnoses. Overall, more than half of all Veterans received MST-related care with an associated mental health primary diagnosis (57% of women and 50% of men); the most common diagnoses were PTSD, depression, and other anxiety disorders.
The authors note that the high proportion of Veterans accessing MST-related care confirms the effectiveness of VA's universal screening program to promote the use of mental health services for Veterans with positive MST screens.
Turchik J, Pavao J, Hyun J, Mark H, and Kimerling R. Utilization and intensity of outpatient care related to military sexual trauma for Veterans from Afghanistan and Iraq. Journal of Behavioral Health Services & Research March 7, 2012;e-pub ahead of print.
Dr. Kimerling is part of HSR&D's Center for Health Care Evaluation, Palo Alto, CA.