Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, United States.
Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, United States.
Clin Psychol Rev. 2017 Apr;53:59-78. doi: 10.1016/j.cpr.2017.01.008. Epub 2017 Feb 4.
Research has demonstrated that military service members are at elevated risk for a range of psychiatric problems, and mental health services use is a conduit to symptom reduction and remission. Nonetheless, there is a notable underutilization of mental health services in this population. This systematic review aimed to identify and critically examine: (1) rates of service use; (2) barriers and facilitators to care; and (3) programs and interventions designed to enhance willingness to seek care and increase help-seeking behaviors among current military personnel (e.g., active duty, National Guard, Reserve). Overall, 111 peer-reviewed articles were identified for inclusion. Across studies, the rate of past-year service use among service members with mental health problems during the same time frame was 29.3% based on weighted averages. Studies identified common barriers to care (e.g., concerns regarding stigma, career impact) and facilitators to care (e.g., positive attitudes toward treatment, family/friend support, military leadership support) among this population. Although programs (e.g., screening, gatekeeper training) have been developed to reduce these barriers, leverage facilitators, and encourage service use, further research is needed to empirically test the effectiveness of these interventions in increasing rates of service utilization. Critical areas for future research on treatment engagement among this high-risk population are discussed.
研究表明，军人面临一系列精神健康问题的风险增加，而使用心理健康服务是减轻和缓解症状的途径。尽管如此，该人群对心理健康服务的利用率明显较低。本系统评价旨在确定并批判性地审查：（1）服务利用率；（2）护理障碍和促进因素；以及（3）旨在提高现役军人（例如现役、国民警卫队、预备役）寻求护理的意愿和增加寻求帮助行为的计划和干预措施。总体而言，确定了 111 篇同行评议的文章纳入本研究。在这些研究中，根据加权平均值，在同一时间段内有精神健康问题的军人过去一年的服务利用率为 29.3%。研究确定了该人群中常见的护理障碍（例如对污名化、职业影响的担忧）和促进因素（例如对治疗、家庭/朋友支持、军队领导支持的积极态度）。尽管已经开发了一些项目（例如筛查、把关人培训）来减少这些障碍，利用促进因素，并鼓励服务利用，但仍需要进一步研究来实证检验这些干预措施在提高服务利用率方面的有效性。讨论了针对这一高风险人群的治疗参与的未来研究的关键领域。
