加拿大退伍军人心理健康服务使用趋势:安大略省基于人群的回顾性队列研究。

Mental Health Services Use Trends in Canadian Veterans: A Population-Based Retrospective Cohort Study in Ontario.

机构信息

1 Evaluative Clinical Sciences, Sunnybrook Health Sciences Centre, Toronto, Ontario.

2 Canadian Institute for Military & Veteran Health Research, Kingston, Ontario.

出版信息

Can J Psychiatry. 2018 Jun;63(6):378-386. doi: 10.1177/0706743717730826. Epub 2017 Sep 14.

Abstract

OBJECTIVE

A substantial evidence base in the peer-reviewed literature exists investigating mental illness in the military, but relatively less is documented about mental illness in veterans. This study uses provincial, administrative data to study the use of mental health services by Canadian veterans in Ontario.

METHOD

This was a retrospective cohort study of Canadian Armed Forces and Royal Canadian Mounted Police veterans who were released between 1990 and 2013 and resided in Ontario. Mental health-related primary care physician, psychiatrist, emergency department (ED) visits, and psychiatric hospitalisations were counted. Repeated measures were presented in 5-year intervals, stratified by age at release.

RESULTS

The cohort included 23,818 veterans. In the first 5 years following entry into the health care system, 28.9% of veterans had ≥1 mental health-related primary care physician visit, 5.8% visited a psychiatrist at least once, and 2.4% received acute mental health services at an ED. The use of mental health services was consistent over time. Almost 8% of veterans aged 30 to 39 years saw a psychiatrist in the first 5 years after release, compared to 3.5% of veterans aged ≥50 years at release. The youngest veterans at release (<30 years) were the most frequent users of ED services for a mental health-related reason (5.1% had at least 1 ED visit).

CONCLUSION

Understanding how veterans use the health care system for mental health problems is an important step to ensuring needs are met during the transition to civilian life.

摘要

目的

同行评议文献中存在大量关于军人心理健康的证据,但关于退伍军人心理健康的记录相对较少。本研究利用省级行政数据研究加拿大安大略省退伍军人使用心理健康服务的情况。

方法

这是一项对加拿大武装部队和加拿大皇家骑警退伍军人的回顾性队列研究,他们于 1990 年至 2013 年期间退伍并居住在安大略省。计算了与心理健康相关的初级保健医生、精神科医生、急诊部 (ED) 就诊次数和精神科住院治疗次数。按退伍时的年龄分层,以 5 年为间隔呈现重复测量结果。

结果

该队列包括 23818 名退伍军人。在进入医疗保健系统后的头 5 年中,28.9%的退伍军人至少有 1 次与心理健康相关的初级保健医生就诊,5.8%的退伍军人至少就诊过 1 次精神科医生,2.4%的退伍军人在 ED 接受过急性心理健康服务。随着时间的推移,对心理健康服务的使用保持一致。在退伍后的头 5 年里,30 至 39 岁的退伍军人中有近 8%的人看过精神科医生,而退伍时年龄≥50 岁的退伍军人中有 3.5%看过精神科医生。退伍时年龄最小的退伍军人(<30 岁)是因心理健康相关原因就诊 ED 的最频繁人群(5.1%至少有 1 次 ED 就诊)。

结论

了解退伍军人如何使用医疗保健系统来解决心理健康问题,是确保他们在向平民生活过渡期间满足需求的重要步骤。

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