Veterans Reporting a History of Military Sexual Trauma are Treated in a Variety of VA Outpatient Mental Health Settings
Military sexual trauma (MST) is associated with substantially elevated rates of mental health conditions; for example, patients with MST are more likely to experience PTSD, anxiety disorders, and depression. Because MST is a stressor rather than a mental health diagnosis, current VA policies focus on detection of MST and access to care for the wide range of associated conditions. This study sought to determine the VA mental health outpatient settings in which patients with MST are most likely to be treated, which might help set priorities for targeted MST-related education and training. Using VA administrative data, investigators indentified 79,903 female Veterans and 889,998 male Veterans with at least one outpatient mental healthcare visit at a VA facility in FY08 who had been screened for MST.
- More than one-third of female Veterans (36%; 26,610) and 2% (21,538) of male Veterans seen in VA outpatient mental healthcare settings during FY08 reported a history of military sexual trauma. Both women and men with MST were more likely to use more than one type of mental health clinic setting, compared to those without MST.
- A significantly larger proportion of women seen in MST specialty clinics reported MST as compared to all other settings (81% vs. 34%). However, there was a wide range of clinic visit settings for female Veterans with MST, including: MST specialty clinics, PTSD specialty clinics, psychosocial rehabilitation, and substance use disorder clinics.
- Male Veterans represented a small proportion of patients seen in all clinics, and a larger proportion of men seen in MST specialty clinics reported MST as compared to other settings (56% vs. 2%).
- These findings indicate that mental health providers who treat women Veterans, even if they work in settings that do not traditionally incorporate interventions focused on traumatic stress, may encounter issues related to MST. Therefore the authors suggest that training in how to respond to sexual trauma disclosure be an important component in all VA mental healthcare settings.
- MST was not necessarily the presenting problem or primary focus of treatment for these patients.
- This study did not include Veterans being treated for MST outside the VA healthcare system.
This study was partly funded by HSR&D (IAE 05-291). All authors are part of VA’s National Center for Post-traumatic Stress Disorder, VA Palo Alto Health Care System, and Dr. Kimerling is part of HSR&D’s Center for Health Care Evaluation, also in Palo Alto, CA.
Valdez C, Kimerling R, Hyun J, et al. Veterans Health Administration Mental Health Treatment Settings of Patients who Report Military Sexual Trauma. Journal of Trauma & Dissociation May 2011;12(3):232-43.