Study Examines Gender Differences in Attitudes and Their Relationship to VA Mental Healthcare Use
OEF/OIF Veterans are at risk for a variety of post-deployment mental health problems, including PTSD, depression, and alcohol abuse. Unfortunately, rates of treatment-seeking among active duty service members and Veterans remain low and do not parallel the high levels of need for care. Along with access to care issues, one of the most important factors that may drive mental health service use among Veterans is their attitude about VA healthcare and mental illness in general. This study explored gender differences in attitudinal barriers to and facilitators of care for OEF/OIF Veterans, and determined the relationship of those factors to VA mental health service use among female and male Veterans with probable mental health conditions. From a national sample, investigators identified 278 OEF/OIF Veterans (164 women and 114 men) with a probable diagnosis of PTSD, depression, or alcohol abuse, who had returned from deployment to Iraq or Afghanistan between 2007 and 2009 – and were separated from service at study time. Study measures assessed mental health symptomatology, positive perceptions of VA care, perceived fit in the VA setting, beliefs about mental illness and treatment, and use of VA mental healthcare in the past six months.
- Female and male OEF/OIF Veterans were similar in their perceptions of VA healthcare and their perceived fit within the VA healthcare setting. Men held slightly more negative attitudes about mental illness and treatment than women.
- For both women and men, perceived entitlement to VA care was associated with increased likelihood of service use, and negative beliefs about treatment seeking (e.g., a problem would have to be really bad to seek mental health treatment) were associated with a reduced likelihood of seeking mental healthcare in the past six months.
- For female Veterans only, positive perceptions of VA healthcare were associated with increased likelihood of seeking VA mental health treatment.
- For male Veterans only, researchers found a positive relationship between VA service use and negative attitudes toward mental health treatment (e.g., mental health treatment does not work). Perceived similarity to other VA healthcare users was also associated with increased likelihood of service use, while negative beliefs about mental illness (e.g., people with mental health problems are violent or dangerous) were associated with lower likelihood of service use.
- Because this was a cross-sectional study, it limits the conclusions that can be drawn regarding the directionality of the relationships between attitudes and service use.
- Because validated measures for perceived fit in the VA setting were not available, investigators developed measures for this study.
- Assessment of perceptions of VA care focused only on use of in-person services.
This study was partly supported by HSR&D (DHI 06-225). Drs. Fox and Vogt are part of VA's National Center for Posttraumatic Stress Disorder and Dr. Vogt also is part of HSR&D's Center for Healthcare Organization and Implementation Research, both located within the VA Boston Healthcare System.
Fox A, Meyer E, and Vogt D. Attitudes about the VA Health-care Setting, Mental Illness, and Mental Health Treatment and their Relationship with VA Mental Health Service Use among Female and Male OEF/OIF Veterans. Psychological Services. November 3, 2014;e-pub ahead of print.