Use and Predictors of Healthcare among New Post-9/11 Veterans with Mental Health Conditions
Most Veterans successfully transition back to their communities, but a significant minority have difficulty reintegrating into civilian life, particularly those with mental health problems. To make the best policy decisions, more information is needed about the types of healthcare Veterans use, the timing of use, and the characteristics of underserved Veterans. This longitudinal study sought to identify the healthcare programs and services that new post-9/11 Veterans who screened positive for mental health problems (n=3,295) used–and any factors that predicted that use within the first 90 days of military separation. Veterans in this study separated from active duty service in the 90 days prior to August-November 2016, and were asked how often they used VA hospitals or clinics, VA Vet Centers, non-VA hospitals/clinics, the Veterans Choice Program, alternative medicine such as acupuncture or chiropractic care, and/or counseling services. Measured covariates included demographics, combat exposure, service rank, and comorbidities (i.e., high blood pressure, chronic pain, PTSD, depression).
- Veterans from the most junior enlisted ranks were the least likely to access healthcare programs and services, whereas few differences emerged by gender or racial/ethnic minority status.
- Nearly half of Veterans in the sample (47%) used VA for their healthcare, while 19% sought services from non-VA providers.
- Veterans exposed to combat, those with a medical discharge, and those with a chronic medical or mental health problem were all more likely to report using VA healthcare services.
- Among the sample, 73% of Veterans screened positive for a probable anxiety disorder, 69% for PTSD, 57% for alcohol misuse, 51% for depression, and 77% reported having at least one physical health problem.
- Findings suggest that Veterans, particularly those from the junior enlisted ranks who are most at risk for poor transitions, should be encouraged to use programs and services provided by both VA and non-VA healthcare alternatives.
- There are limitations in the use of mental health screeners to estimate the prevalence of mental health problems within a population. The screeners used in this study were extremely brief and were not validated by subsequent diagnoses.
- Questions about program use were not validated against VA clinical records.
This study was partly funded by HSR&D. Dr. Vogt is part of the National Center for PTSD, VA Boston Healthcare System and HSR&D’s Center for Healthcare Organization & Implementation Research (CHOIR). Dr. Copeland is part of the VA Central Western Massachusetts Healthcare System, Leeds, MA. Dr. Finley is with the Veterans Evidence-based Research Dissemination and Implementation Center, San Antonio, TX.
Aronson K, Perkins D, Morgan N, Bleser J, Vogt D, Copeland L, Finley E, and Gilman C. Use of Health Services among Post-9/11 Veterans with Mental Health Conditions within 90 Days of Separation from the Military. Psychiatric Services. May 12, 2020; Epub ahead of print.