More than One in Eight Women Veterans Screen Positive for PTSD and A Significant Segment Does Not Receive Treatment
BACKGROUND:
Though military service confers an increased risk for subsequent development of PTSD, estimates of PTSD prevalence among Veterans are limited to specific war cohorts or to VA healthcare users. Therefore, the risk of PTSD in the general women Veteran population is unknown. This study sought to identify PTSD prevalence and mental healthcare use in a representative national sample of women Veterans. Using data from the National Survey of Women Veterans — a population-based, cross-sectional survey conducted from 2008 to 2009 — investigators identified 3,611 women Veterans. Characteristics and mental healthcare use were then compared between women Veterans who screened positive for PTSD and those who screened negative, including: demographics, military service, combat exposure, military sexual assault, disability status, overall health status, as well as positive screening for depression, anxiety, and/or alcohol abuse.
FINDINGS:
- More than one in eight women Veterans in this study (13%) screened positive for PTSD, and less than half of this group received mental health treatment (either VA or non-VA).
- VA healthcare was used by 31% of the women Veterans who screened positive for PTSD and by 11% of women Veterans who screened negative for PTSD. Among women Veterans who screened positive, 49% used mental healthcare services, including 66% of VA users and 41% of non-VA users.
- Predictors of mental healthcare use included having a diagnosis of depression and utilizing VA healthcare, while lacking a regular healthcare provider and household income below the federal poverty line predicted non-use of mental healthcare.
- Because the majority of women Veterans utilize non-VA healthcare, and these providers may be unaware of their Veteran status and PTSD risk, the authors suggest that more effective efforts be made to help identify women Veterans with PTSD — and to engage them in care.
LIMITATIONS:
- The screening instrument used in this study was not equivalent to clinical diagnostic evaluation.
- Many OEF/OIF Veterans may have readjustment disorder that will not develop into PTSD, and they may have been more likely to have had a false positive screen. Therefore, error in estimations of screening prevalence may not be uniform across all Veteran populations.
AUTHOR/FUNDING INFORMATION:
This study was partly funded by HSR&D (IAE 06-083, SDR 08-270). Dr. Yano also was supported by an HSR&D Research Career Scientist Award. All authors are part of HSR&D's Center for the Study of Healthcare Provider Behavior, in Sepulveda, CA (Dr. Yano is Director).
Washington DL, Davis TD, Der-Martirosian C, and Yano EM. PSTD Risk and Mental Health Care Engagement in a Multi-War Era Community Sample of Women Veterans. Journal of General Internal Medicine February 23, 2013;e-pub ahead of print.
