Fikretoglu Deniz, Guay Stéphane, Pedlar David, Brunet Alain
Douglas Hospital Research Centre, McGill University, Montreal, Quebec, Canada.
Med Care. 2008 Feb;46(2):217-23. doi: 10.1097/MLR.0b013e31815b979a.
Mental disorders constitute a significant public health problem in active military populations. However, very little is known about patterns of mental health service use in these populations.
The primary objective of this study was to examine the patterns and predictors of mental health service use in active Canadian Force members. Additional objectives included identification of barriers to service use.
A cross-sectional analysis was conducted using data from the Canadian Community Health Survey-Canadian Forces Supplement.
Participants were assessed for mood, anxiety, and substance use disorders using the World Health Organization's Composite International Diagnostic Interview. Those who met criteria for at least 1 disorder in the past year (n = 1220) were included in the analyses.
Of military members with a 12-month diagnosis, 42.6% used services in the past year. Predictors of service use included mental health indicators, gender, marital status, and military rank. Of military members who failed to use services, only a small percentage (3.5-16.0%) acknowledged a need for services. These members perceived a number of barriers to services, foremost among which was lack of trust in military health, administrative, and social services.
Despite recent efforts to de-stigmatize mental health problems and treatments, unmet need for mental health services remains a significant problem in active militaries. Our findings indicate that military institutions should continue public education campaigns to de-stigmatize mental health problems and should make necessary changes in health delivery systems to gain the trust of military members.
精神障碍在现役军人中是一个重大的公共卫生问题。然而,对于这些人群使用心理健康服务的模式却知之甚少。
本研究的主要目的是调查加拿大现役军人使用心理健康服务的模式及预测因素。其他目的包括确定使用服务的障碍。
使用来自加拿大社区健康调查——加拿大军队补充调查的数据进行横断面分析。
使用世界卫生组织的综合国际诊断访谈对参与者的情绪、焦虑和物质使用障碍进行评估。过去一年中符合至少一种障碍标准的人(n = 1220)被纳入分析。
在过去12个月被诊断出患有疾病的军人中,42.6%在过去一年使用了服务。使用服务的预测因素包括心理健康指标、性别、婚姻状况和军衔。在未使用服务的军人中,只有一小部分(3.5 - 16.0%)承认需要服务。这些军人认为存在一些服务障碍,其中最主要的是对军队医疗、行政和社会服务缺乏信任。
尽管最近努力消除对心理健康问题和治疗的污名化,但现役军人中未满足的心理健康服务需求仍然是一个重大问题。我们的研究结果表明,军事机构应继续开展公众教育活动以消除对心理健康问题的污名化,并应在医疗服务体系中做出必要改变以赢得军人的信任。