Study Suggests Social Network Encouragement Helps Veterans with PTSD Seek VA Mental Healthcare
BACKGROUND:
Approximately 8% of the five million Veterans using VA healthcare have been diagnosed with PTSD. Untreated PTSD can become chronic and can lead to hospitalization, unemployment, poverty, suicide, and poor health. This prospective, national cohort study sought to determine whether beliefs about mental health treatment and/or social encouragement to seek treatment influence initiation of mental healthcare among Veterans with PTSD. Using VA data, investigators identified 7,645 Veterans recently diagnosed with PTSD (between 6/08 and 7/09) who were not receiving VA mental healthcare. Within two weeks of a diagnosis of PTSD by a VA clinician, Veterans were sent a survey that assessed PTSD severity, mental health quality of life, anticipated access barriers, treatment-related beliefs, and whether VA healthcare users received encouragement from those in their social network to seek care. VA administrative data were used to identify demographic and facility level determinants of care, and to determine whether Veterans initiated VA mental healthcare in the six months after the PTSD diagnosis was made.
FINDINGS:
- Whether Veterans initiate mental healthcare after a PTSD diagnosis depends not only on symptom severity and access to treatment, but also on encouragement by those in their social network, whether the Veteran perceives the need for treatment, how they view treatment for PTSD (e.g., positive beliefs about the efficacy of antidepressants), as well as their ability to follow treatment recommendations.
- Encouragement to get mental healthcare by individuals in their social network increased the odds of getting treatment, even after controlling for beliefs, particularly if encouragement was given by both family and friends/other Veterans.
- While not the focus of this study, investigators noted that for all outcomes, older VA healthcare users, Veterans with service connection, and those who were diagnosed in non-mental health clinics were less likely to receive treatment. In addition, Veterans who were seen in PTSD specialty clinics, though less likely to receive medication than those in general mental health clinics, were more likely to receive psychotherapy.
LIMITATIONS:
- Mental health services provided outside VA were not included in this study.
- Self-report measures may not have fully captured the study domains of interest.
IMPLICATIONS:
- Involving family members and others in Veterans' social networks and addressing treatment-related beliefs may be effective strategies to engage more Veterans with PTSD in mental health treatment.
AUTHOR/FUNDING INFORMATION:
This study was funded by HSR&D (IAC 06-266). All authors are part of HSR&D's Center for Chronic Disease Outcomes Research, Minneapolis, MN.
Spoont M, Nelson D, Murdoch M, et al. Impact of Beliefs and Social Facilitation on Mental Health Care Initiation among VA Service Users with PTSD. Psychiatric Services February 3, 2013;e-pub ahead of print.
