Durham Veterans Affairs (VA) Health Care System.
VA Salt Lake City Healthcare System.
Psychol Serv. 2023;20(Suppl 2):213-221. doi: 10.1037/ser0000683. Epub 2022 Jul 4.
Depression and posttraumatic stress disorder (PTSD) are two of the most common mental health conditions experienced by veterans. It is unclear what individual and system level factors are associated with receiving mental health treatment for these concerns. Using a national sample of Gulf War Era veterans who endorsed lifetime diagnoses of either depression or PTSD ( = 425), regression analyses were used to predict past-year treatment utilization. Predictor variables were those indicated in the behavioral model of health care utilization, including predisposing demographic variables (e.g., age, race), enabling variables (e.g., service connection, enrollment in Veterans Health Administration [VHA]), and need-based variables (e.g., current symptom severity). VHA enrollment was associated with a three- and five-times higher odds of being treated for depression or PTSD, respectively. Income and symptom severity were also positively associated with treatment utilization. Among individuals with diagnoses of depression and/or PTSD, VHA enrollment was the strongest predictor of receiving mental health treatment for these diagnoses, controlling for all other variables in the model including recent contact with the health care system, current symptom severity, and the presence of other enabling resources. Results suggest that the VHA's integrated model of care increases accessibility and delivery of effective mental health services. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
抑郁和创伤后应激障碍(PTSD)是退伍军人最常见的两种心理健康问题。目前尚不清楚哪些个体和系统层面的因素与这些问题的心理健康治疗有关。本研究使用了一个有海湾战争经历的退伍军人的全国性样本,这些退伍军人在一生中都被诊断为抑郁或 PTSD(=425)。回归分析用于预测过去一年的治疗利用情况。预测变量是卫生保健利用行为模型中所指出的变量,包括易感性人口统计学变量(如年龄、种族)、促成变量(如服务联系、退伍军人事务部[VHA]的注册)和需求相关变量(如当前症状严重程度)。VHA 的注册与接受抑郁或 PTSD 治疗的几率分别增加了三倍和五倍。收入和症状严重程度也与治疗利用率呈正相关。在有抑郁和/或 PTSD 诊断的个体中,VHA 的注册是接受这些诊断的心理健康治疗的最强预测因素,控制了模型中包括最近与医疗保健系统的接触、当前症状严重程度和其他可用资源在内的所有其他变量。结果表明,VHA 的综合护理模式提高了获得和提供有效心理健康服务的机会。(PsycInfo 数据库记录(c)2023 APA,保留所有权利)。