1
|
ER F, DUYAN V. An Overview of the Stigmatization of Soldiers in the Context of Mental Health from a Social Work Perspective. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1163149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/15/2023]
Abstract
Due to its nature, the army is an environment with a high risk of mental illness. Research shows that mental health stigma is a common and serious barrier to early and effective treatment for mental disorders that result from the stress of military operations. Given the need for timely and effective mental health intervention, it is important to understand the barriers to seeking mental health help in a military context. Although there is stigma related to mental health in the studies and compilations carried out in the civil and military context in the national and international literature, there is no literature on mental health stigmatization in the military context, especially in the national literature. This study is a compilation research created by reviewing the national and international literature. In this article, it is aimed to present some innovative social work interventions in order to address the sources of stigma that hinders access to mental health care and the factors that reinforce them, in a military context, to potentially reduce stigma and to maximize the benefit of mental health care.
Collapse
Affiliation(s)
- Filiz ER
- Van İl Sağlık Müdürlüğü, İpek Yolu İlçe Sağlık Müdürlüğü
| | - Veli DUYAN
- ANKARA ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ ENSTİTÜSÜ
| |
Collapse
|
2
|
Pebole MM, Singleton CR, Hall KS, Petruzzello SJ, Alston RJ, Whitworth JW, Gobin RL. Impact of Military Affiliation on Exercise Perceptions Among Survivors of Sexual Violence. Mil Med 2023; 188:e2257-e2265. [PMID: 36653919 DOI: 10.1093/milmed/usac431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/06/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Military service members disproportionately experience sexual violence (SV) and its related health concerns. Although recent work has shown physical activity to be an effective strategy for improving physical and mental health among trauma-exposed military populations, little of this work has focused specifically on military service members with a history of SV. To address these gaps in knowledge and practice, this study identified the most salient perceived benefits/barriers of exercise among men and women survivors of SV with military affiliations. Additionally, these analyses explore willingness to engage in exercise programs, and preferences for the structure/content of these programs, among men and women survivors of SV with military affiliations. MATERIALS AND METHODS An online, cross-sectional survey of women (n = 355) and men (n = 198) survivors of SV was completed using Amazon Mechanical Turk. Inclusion criteria were men and women, age between 18 and 65 years, self-reported history of SV, and located in the United States. Information on sociodemographics and post-traumatic stress disorder symptoms was collected alongside perceived barriers and benefits to exercise, willingness to engage in exercise programs, and preferences for the structure/content of these programs. Analyses were stratified by sex. Comparisons by history of military involvement (active duty military or veteran; no military involvement/civilian) were reported. RESULTS Both military-involved men (n = 68) and women (n = 139) were more likely to prefer at-home and online exercise options when compared to civilians (Ps < .05; Cramer's Vs 0.19-0.36). Additionally, both men and women with military involvement reported strongly favoring exercising with an instructor over no instructor and preferred that this instructor identifies with their same gender (Ps < .01; Cramer's Vs 0.28-0.36). Women with military involvement also preferred shorter program durations and exercising alone or in a group online or in person, whereas men with military involvement were open to longer program durations, when compared to their civilian counterparts (Ps < .05; Cramer's Vs 0.19-0.37). Women and men with military involvement were more likely than their civilian counterparts to perceive that exercise benefits their psychological outlook and social interactions. They were also more likely than civilians to indicate poor exercise environment, high time expenditure, and family discouragement as perceived barriers to exercise (Ps < .05; Cohen's ds 0.21-0.97). Military-involved women were also more likely than civilian women to endorse the perceived barrier of hard physical exercise (P < .05; Cohen's d = 0.25). CONCLUSIONS This study identified perceived benefits and barriers to exercise, along with willingness to engage in exercise programs, and exercise preferences among men and women survivors of SV with military involvement. Targeting these factors in intervention planning will be important for physical activity promotion and program engagement among veterans to reduce the disproportionate impact of SV and disease burden among U.S. service members and veterans.
Collapse
Affiliation(s)
- Michelle M Pebole
- The Translational Research Center for TBI and Stress Disorders (TRACTS), Veterans Affairs Boston Healthcare System, Boston, MA 02130, USA
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61280, USA
| | - Chelsea R Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, New Orleans, LA 70112, USA
| | - Katherine S Hall
- Department of Medicine, Duke University, Durham, NC 27710, USA
- Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs Healthcare System, Durham, NC 27705, USA
| | - Steven J Petruzzello
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61280, USA
| | - Reginald J Alston
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61280, USA
| | - James W Whitworth
- National Center for PTSD, Behavioral Science Division, Veterans Affairs Boston Healthcare System, 150 S Huntington Ave, Boston, MA 02130, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA
| | - Robyn L Gobin
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61280, USA
| |
Collapse
|
3
|
Schinkel KR, Budowle R, Porter CM, Dai B, Gifford C, Keith JF. Service, Scholarship, and Sacrifice: A Qualitative Analysis of Food Security Barriers and Strategies among Military-Connected Students. J Acad Nutr Diet 2023; 123:454-465. [PMID: 35809781 DOI: 10.1016/j.jand.2022.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND In the United States, 41% of 4-year university student veterans have reported food insecurity, but literature on food insecurity among military-connected students is limited. OBJECTIVE The objective of the study was to increase knowledge of military-connected student food insecurity experiences and potential strategies to address food access. DESIGN The study is a cross-sectional survey and nonexperimental qualitative cohort analysis. PARTICIPANTS AND SETTING Military-connected students (n = 127) responded to a survey sampling all enrolled students at a Mountain West land grant university during spring 2020. Military-connected student focus group participants (n = 8) were purposively sampled from the same university during fall 2020. MAIN OUTCOME MEASURES Main outcome measures were demographic data and food insecurity rates. Qualitative measures included responses to questions about food insecurity among military-connected students, actions for improving food insecurity, and insight into food access resources on campus. STATISTICAL ANALYSIS Descriptive statistics were used to determine food insecurity rates. Qualitative analysis included audio recording and transcription, then a step-by-step process for coding and theme development. RESULTS Food insecurity was reported by 42.5% of military-connected student survey respondents. Qualitative analysis revealed themes about current and planned food access resources, barriers to food security, and strategies to promote military-connected student food security. Main themes related to resources were access to resources and food offerings. Main barrier themes were pride and shame. Main strategy themes included military pride and military connections and culture. CONCLUSIONS Military-connected students are at least as vulnerable to food insecurity as the student body at large. Qualitative analysis identified barriers and strategies for food security among military-connected students. Feelings of pride in identifying with the military seemed to amplify feelings of shame about food insecurity; however, this pride and sense of military community also suggest that food security efforts specifically tailored to military-connected students could be successful.
Collapse
Affiliation(s)
- Kerry R Schinkel
- VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Rachael Budowle
- Haub School of Environment and Natural Resources, University of Wyoming, Laramie, Wyoming
| | | | - Boyi Dai
- Kinesiology and Health, University of Wyoming, Laramie, Wyoming
| | - Cody Gifford
- Animal Science, University of Wyoming, Laramie, Wyoming
| | - Jill F Keith
- Family and Consumer Sciences, University of Wyoming, Laramie, Wyoming.
| |
Collapse
|
4
|
Dawud LM, Holbrook EM, Lowry CA. Evolutionary Aspects of Diverse Microbial Exposures and Mental Health: Focus on "Old Friends" and Stress Resilience. Curr Top Behav Neurosci 2023; 61:93-117. [PMID: 35947354 PMCID: PMC9918614 DOI: 10.1007/7854_2022_385] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The prevalence of inflammatory disease conditions, including allergies, asthma, and autoimmune disorders, increased during the latter half of the twentieth century, as societies transitioned from rural to urban lifestyles. A number of hypotheses have been put forward to explain the increasing prevalence of inflammatory disease in modern urban societies, including the hygiene hypothesis and the "Old Friends" hypothesis. In 2008, Rook and Lowry proposed, based on the evidence that increased inflammation was a risk factor for stress-related psychiatric disorders, that the hygiene hypothesis or "Old Friends" hypothesis may be relevant to psychiatric disorders. Since then, it has become more clear that chronic low-grade inflammation is a risk factor for stress-related psychiatric disorders, including anxiety disorders, mood disorders, and trauma- and stressor-related disorders, such as posttraumatic stress disorder (PTSD). Evidence now indicates that persons raised in modern urban environments without daily contact with pets, relative to persons raised in rural environments in proximity to farm animals, respond with greater systemic inflammation to psychosocial stress. Here we consider the possibility that increased inflammation in persons living in modern urban environments is due to a failure of immunoregulation, i.e., a balanced expression of regulatory and effector T cells, which is known to be dependent on microbial signals. We highlight evidence that microbial signals that can drive immunoregulation arise from phylogenetically diverse taxa but are strain specific. Finally, we highlight Mycobacterium vaccae NCTC 11659, a soil-derived bacterium with anti-inflammatory and immunoregulatory properties, as a case study of how single strains of bacteria might be used in a psychoneuroimmunologic approach for prevention and treatment of stress-related psychiatric disorders.
Collapse
Affiliation(s)
- Lamya'a M Dawud
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Evan M Holbrook
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Christopher A Lowry
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA.
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA.
- Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, USA.
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
- Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, USA.
- Center for Neuroscience, University of Colorado Boulder, Boulder, CO, USA.
- Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, USA.
- inVIVO Planetary Health, Worldwide Universities Network (WUN), West New York, NJ, USA.
| |
Collapse
|
5
|
Connolly CE, Norris K, Dawkins S, Martin A. Barriers to mental health help-seeking in veterinary professionals working in Australia and New Zealand: A preliminary cross-sectional analysis. Front Vet Sci 2022; 9:1051571. [PMID: 36406072 PMCID: PMC9671929 DOI: 10.3389/fvets.2022.1051571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
Despite higher reported rates of mental ill-health than the general population, professionals working in the animal care industry have low reported rates of help-seeking behavior. Potential factors involved in veterinary professionals' reluctance to seek help include stigma toward mental ill-health, practical barriers to accessing supports, and a cultural normalization of symptoms in the industry. This preliminary study sought to explore these factors in a sample of veterinarians, veterinary nurses, and veterinary technicians and examine effects of gender, years' experience, and practice location. A total of 408 veterinary professionals working in Australia and New Zealand completed an online survey between June and December 2021 measuring perceived stigma, practical barriers to mental health help-seeking, perceptions of normalized psychopathology and sickness presenteeism. Results indicated moderate levels of both perceived stigma and barriers to mental health help-seeking. Interestingly, psycho/pathology (e.g., burnout, fatigue, and sickness presenteeism) was perceived to be a normalized aspect of the profession by majority of respondents. Although no effect of gender or geographic location were observed, stage of career did have an effect on findings. Early career veterinary professionals were identified as more vulnerable to perceived stigma and barriers to care. The practical and research implications of the findings are discussed and include the need for mental health to be more centrally incorporated into the veterinary curriculum and professional development. Also discussed is an agenda for future research aimed at improving the mental health and wellbeing of professionals working in the animal care industry.
Collapse
Affiliation(s)
- Caitlin Elizabeth Connolly
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia
- *Correspondence: Caitlin Elizabeth Connolly
| | - Kimberley Norris
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia
| | - Sarah Dawkins
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia
| | - Angela Martin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| |
Collapse
|
6
|
The “trauma pitch”: How stigma emerges for Iraq and Afghanistan veterans seeking disability compensation. PLoS One 2022; 17:e0267424. [PMID: 36044465 PMCID: PMC9432745 DOI: 10.1371/journal.pone.0267424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/16/2022] [Indexed: 11/21/2022] Open
Abstract
Posttraumatic Stress Disorder continues to be a highly stigmatized disease for the veteran population and stigma, experienced as a mark of discredit or shame, continues to be identified as the main deterrent in treatment seeking. Little attention has been paid to how the process of obtaining service-connected disability status can amplify veterans’ perceptions of being stigmatized. The following ethnographic study identified how combat veterans experienced stigma in processing through Veterans Affairs care and the effects of linking a Posttraumatic Stress Disorder diagnosis with disability compensation. Stigma was identified in two inter-related areas: 1) the structural level in the Veterans Affairs disability claims process and 2) the individual level in interactions with Veterans Affairs service providers. Findings based on veterans’ narratives suggest that the disability claims process, requiring multiple repetitions of personal trauma, coupled with perceptions of institutional stigmas of malingering, created bureaugenic effects: a worsening of symptoms caused by bureaucratic protocols intended to help veterans. This process influenced first time treatment users of the Veterans Affairs by deterring treatment-seeking behavior but was not found to affect veterans who had already initiated treatment. Despite the experience of stigma and commodification of their suffering through disability and diagnostic screening, veterans still sought disability compensation. Veterans viewed this compensation as acknowledgment of their loss and validation of their sacrifice.
Collapse
|
7
|
Farrell D, Fadeeva A, Zat Z, Knibbs L, Miller P, Barron I, Matthess H, Matthess C, Gazit N, Kiernan MD. A Stage 1 Pilot Cohort Exploring the Use of EMDR Therapy as a Videoconference Psychotherapy During COVID-19 With Frontline Mental Health Workers: A Proof of Concept Study Utilising a Virtual Blind 2 Therapist Protocol. Front Psychol 2022; 13:901855. [PMID: 35874361 PMCID: PMC9298740 DOI: 10.3389/fpsyg.2022.901855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/19/2022] [Indexed: 02/05/2023] Open
Abstract
Objective The COVID-19 pandemic has had a major impact on the delivery of psychological treatment. Due to social distancing requirements, the provision moved to videoconferencing psychotherapy (VCP). There is a paucity of empirical data supporting the efficacy of EMDR therapy as a VCP. This stage 1 pilot study tested an EMDR therapy scripted protocol, such as Virtual Blind 2 Therapist (VB2Tr), on frontline mental health workers as a VCP regarding fitness for purpose, distinctiveness, relevance, and efficiency. Methods A total of 24 participants were recruited for the study. The design included a one-session treatment intervention with pre, post, 1-month, and 6-month follow-up (FU) measurements. This treatment session used a “Blind 2 Therapist” EMDR therapy scripted protocol as videoconference psychotherapy that involves non-disclosure of traumatic memory. The research explored the treatment effect on the core characteristics of trauma memory, including subjective disturbance, belief systems, memory intensity (MI), vividness, and levels of emotionality. Additionally, the research explored participants’ experiences of adverse and benevolent childhood experiences (ACEs/BCEs) during their childhood. Results Regarding the four tests, namely, fitness for purpose, distinctiveness, relevance, and efficiency, results are favourably suggesting potential clinical benefits of using EMDR as videoconference psychotherapy. Although this is a proof-of-concept study showing positive results, no clinical population or control group was used. The purpose of the study is to explore the potential for scalability toward a larger clinical trial. The treatment intervention was achieved irrespective of either ACEs/BCEs during childhood. Conclusion The research tentatively supports the case for EMDR therapy as a credible treatment when used as video conference psychotherapy and in using the Blind 2 Therapist protocol. However, more research is needed to scale toward a clinical trial. Clinical Trial Registration Clinical Trial Registration:https://www.isrctn.com/ISRCTN12099530, identifier ISRCTN12099530.
Collapse
Affiliation(s)
- Derek Farrell
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Anastasia Fadeeva
- Northern Hub for Veteran and Military Families' Research, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Zeynep Zat
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Lorraine Knibbs
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Paul Miller
- Mirabilis Health Institute, Newtownabbey, United Kingdom
| | - Ian Barron
- Centre for International Education, College of Education, University of Massachusetts, Amherst, MA, United States
| | - Helga Matthess
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | - Cordula Matthess
- Department for Violence Prevention, Trauma and Criminology (VPTC), School of Psychology, University of Worcester, Worcester, United Kingdom
| | | | - Matthew D Kiernan
- Northern Hub for Veteran and Military Families' Research, Northumbria University, Newcastle upon Tyne, United Kingdom
| |
Collapse
|
8
|
Watkins LE, Patton SC, Drexler K, A. M. Rauch S, Rothbaum BO. Clinical Effectiveness of an Intensive Outpatient Program for Integrated Treatment of Comorbid Substance Abuse and Mental Health Disorders. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
9
|
Brenner LA, Stearns-Yoder KA, Stamper CE, Hoisington AJ, Brostow DP, Hoffmire CA, Forster JE, Donovan ML, Ryan AT, Postolache TT, Lowry CA. Rationale, design, and methods: A randomized placebo-controlled trial of an immunomodulatory probiotic intervention for Veterans with PTSD. Contemp Clin Trials Commun 2022; 28:100960. [PMID: 35812820 PMCID: PMC9260450 DOI: 10.1016/j.conctc.2022.100960] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 06/14/2022] [Accepted: 06/27/2022] [Indexed: 12/15/2022] Open
Abstract
Background United States military Veterans from recent conflicts are experiencing symptoms related to posttraumatic stress disorder (PTSD). Many Veterans are resistant to conventional health and mental health interventions (e.g., medication, psychotherapy). Alternative treatment approaches are needed. An underlying feature of PTSD is exaggerated inflammation, both peripherally and in the central nervous system. This inflammation is thought to play an important role in the vulnerability to, aggravation of, and persistence of PTSD symptoms. Therefore, an innovative intervention strategy would be the use of immunoregulatory/anti-inflammatory probiotics to reduce inflammation. Here we describe the rationale, design, and methods of a randomized placebo-controlled trial (RCT) of Lactobacillus rhamnosus GG (LGG; ATCC 53103) for posttraumatic stress disorder (PTSD). Methods This is a Phase IIa trial of LGG for United States military Veterans with PTSD, using a longitudinal, double-blind, randomized placebo-controlled design. The primary outcome measure is plasma concentration of high-sensitivity C-reactive protein. Conclusion Despite the fact that symptoms associated with PTSD can be disabling, individuals living with this trauma-related disorder have limited options in terms of evidence-based interventions. Recent research efforts aimed at highlighting the biological mechanisms of PTSD suggest that increased inflammation and altered autonomic nervous system activity may be treatment targets, and that immunoregulatory probiotics, such as LGG, have the potential to decrease trauma-induced inflammatory responses, as well as associated symptoms. This manuscript describes the best powered human subjects Phase IIa trial, to date, of a probiotic intervention for those living with PTSD.
Collapse
Affiliation(s)
- Lisa A. Brenner
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, United States,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States,Departments of Psychiatry and Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States,Corresponding author. VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, United States.
| | - Kelly A. Stearns-Yoder
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, United States,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States
| | - Christopher E. Stamper
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, United States,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States
| | - Andrew J. Hoisington
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, United States,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States,Department of Systems Engineering & Management, Air Force Institute of Technology, Wright-Patterson AFB, OH, United States
| | - Diana P. Brostow
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, United States,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States
| | - Claire A. Hoffmire
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, United States,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States
| | - Jeri E. Forster
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, United States,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States
| | - Meghan L. Donovan
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, United States,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Arthur T. Ryan
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, United States,Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Teodor T. Postolache
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, United States,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States,Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, United States,VISN 5 MIRECC, Department of Veterans Affairs, Baltimore, MD, United States
| | - Christopher A. Lowry
- VA Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional VA Medical Center (RMRVAMC), Aurora, CO, United States,Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States,Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, United States,Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States,Center for Neuroscience, University of Colorado Boulder, Boulder, CO, United States,Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| |
Collapse
|
10
|
Geppert C. Green Alerts: Balancing Suicide Risk and Privacy. Fed Pract 2022; 39:200-201. [PMID: 35935924 PMCID: PMC9351736 DOI: 10.12788/fp.0273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Cynthia Geppert
- Editor-in-Chief; Professor and Director of Ethics Education at the University of New Mexico School of Medicine in Albuquerque
| |
Collapse
|
11
|
“Putting Down and Letting Go”: An Exploration of a Community-Based Trauma-Oriented Retreat Program for Military Personnel, Veterans, and RCMP. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2020009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Current military members, veterans, and Royal Canadian Mounted Police (RCMP) experience higher rates of posttraumatic stress disorder (PTSD) and moral injury (MI). Trauma-oriented retreats have been offered as a means of addressing these concerns. This article aims to explore the impact of a non-evidence-based trauma-oriented retreat for the above populations experiencing PTSD or MI; (2) Methods: This qualitative study, nested within the larger mixed-methods pre/post longitudinal follow-up study, examined the experiences of 124 military members, veterans, and RCMP who participated in the retreat. Data were collected from semi-structured interviews and first-hand observations of the organization. Analysis was conducted using thematic analysis while being informed by realist evaluation principles; (3) Results: The results showed that important contextual elements were related to participants being ready, having multiple comorbidities and using the program as a first or last resort. Effectual mechanisms included a home-like setting; immersion; credibility of facilitators; experiential learning; an holistic approach; letting go, and reconnecting to self. Outcomes included: re-finding self, symptom management, social connection, and hope for a meaningful life. The gendered analysis suggested less favorable results; (4) Conclusions: Care is warranted as the evidence-base and effectiveness of trauma-oriented retreats yet needs to be established prior to broad use.
Collapse
|
12
|
Seeking treatment for mental illness and substance abuse: A cross-sectional study on attitudes, beliefs, and needs of military personnel with and without mental illness. J Psychiatr Res 2022; 147:221-231. [PMID: 35065512 DOI: 10.1016/j.jpsychires.2022.01.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/21/2021] [Accepted: 01/09/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Often, military personnel do not seek treatment for mental illness or wait until they reach a crisis point. Effective, selective, and indicated prevention is best achieved by seeking treatment early. AIMS We aimed to examine military personnel's attitudes, beliefs, and needs around seeking treatment for mental illness. We compared those who sought treatment to those who did not and those with and without the intention to seek treatment. Finally, we examined factors associated with intentions of not seeking treatment. METHOD We conducted a cross-sectional questionnaire study of military personnel with (N = 324) and without (N = 554) mental illness. Descriptive and regression analyses (logistic and ordinal) were performed. RESULTS The majority of the personnel believed treatment was effective (91.6%); however, most preferred to solve their own problems (66.0%). For personnel with mental illness, compared to those who sought treatment, those who did not had a higher preference for self-management and found advice from others less important. For those without mental illness, those with no intention to seek treatment indicated a higher preference for self-management, stigma-related concerns, denial of symptoms, lower belief in treatment effectiveness and found it less important to be an example, compared to those with treatment-seeking intentions. A clear indication of where to seek help was the most reported need (95.7%). Regression analyses indicated that not seeking treatment was most strongly related to preference for self-management (OR(95%CI) = 4.36(2.02-9.39); no intention to seek treatment was most strongly related to a lower belief that treatment is effective (OR(95%CI) = .41(0.28-0.59) and with not having had positive earlier experiences with treatment seeking (OR(95%CI) = .34(0.22-0.52). CONCLUSIONS To facilitate (early) treatment seeking, interventions should align with a high preference for self-management, mental illness stigma should be targeted, and a clear indication of where to seek treatment is needed.
Collapse
|
13
|
Ross AM, DeVoe ER, Steketee G, Spencer R, Richter M. "This is not your Life…and it becomes your Life": A Qualitative Exploration of Deployment-related Stress and Support needs in National Guard and Reserve spouses who are Mothers of Young Children. FAMILY PROCESS 2021; 60:1364-1380. [PMID: 33247431 DOI: 10.1111/famp.12622] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The adverse effects of deployment-related stress (DRS) on military service members, spouses, and children are well documented. Findings from a recent Consensus Report on Military Families by the National Academies of Science, Engineering, and Medicine (2019) underscore the priority of gaining a more comprehensive understanding of the diversity of today's military families and their needs and well-being. While social support is generally regarded as helpful during times of stress, it has not been studied extensively in National Guard/Reserve spouses who are parents of young children. This qualitative study of 30 women examines the unique ways in which DRS affects women who are National Guard/Reserve spouses and mothers of young children, as well as the processes through which they encountered support to manage these stressors. Salient themes spanned experiences involving deployment cycle phases of separation and reintegration and included both anticipated and unanticipated changes in family-related division of labor, dynamics, and communication patterns. These were complicated by geographic, social, and cultural isolation and misguided efforts to support spouses initiated by civilians. Women managed these stressors primarily through seeking, acquiring, and repurposing existing sources of informal social support for themselves and formal supports for their children, with varying degrees of success.
Collapse
Affiliation(s)
- Abigail M Ross
- Fordham University Graduate School of Social Service, New York, NY, USA
| | - Ellen R DeVoe
- Boston University School of Social Work, Boston, MA, USA
| | - Gail Steketee
- Boston University School of Social Work, Boston, MA, USA
| | - Renée Spencer
- Boston University School of Social Work, Boston, MA, USA
| | | |
Collapse
|
14
|
McGuffin JJ, Riggs SA, Raiche EM, Romero DH. Military and Veteran help-seeking behaviors: Role of mental health stigma and leadership. MILITARY PSYCHOLOGY 2021. [DOI: 10.1080/08995605.2021.1962181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- James J. McGuffin
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Shelley A. Riggs
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Emily M. Raiche
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Daniel H. Romero
- Department of Psychology, University of North Texas, Denton, Texas, USA
| |
Collapse
|
15
|
Heyman RE, Slep AMS, Parsons AM, Ellerbeck EL, McMillan KK. Systematic Review of the Military Career Impact of Mental Health Evaluation and Treatment. Mil Med 2021; 187:e598-e618. [PMID: 34322709 DOI: 10.1093/milmed/usab283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/10/2021] [Accepted: 06/30/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Military leaders are concerned that active duty members' fear of career impact deters mental health (MH) treatment-seeking. To coalesce research on the actual and perceived consequences of MH treatment on service members' careers, this systematic review of literature on the U.S. Military since 2000 has been investigating the following three research questions: (1) is the manner in which U.S. active duty military members seek MH treatment associated with career-affecting recommendations from providers? (2) Does MH treatment-seeking in U.S. active duty military members impact military careers, compared with not seeking treatment? (3) Do U.S. active duty military members perceive that seeking MH treatment is associated with negative career impacts? MATERIALS AND METHODS A search of academic databases for keywords "military 'career impact' 'mental health'" resulted in 653 studies, and an additional 51 additional studies were identified through other sources; 61 full-text articles were assessed for eligibility. A supplemental search in Medline, PsycInfo, and Google Scholar replacing "career impact" with "stigma" was also conducted; 54 articles (comprising 61 studies) met the inclusion criteria. RESULTS As stipulated by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, studies were summarized on the population studied (U.S. Military Service[s]), sample used, intervention type, comparison group employed, outcome variables, and findings. Self-referred, compared with command-directed, service members appear to be less likely to face career-affecting provider recommendations in non-deployed and deployed settings although the data for the latter are not consistent. Of the two studies that tested if MH treatment actually negatively impacts military careers, results showed that those who sought treatment were more likely to be discharged although the casual nature of this relationship cannot be inferred from their design. Last, over one-third of all non-deployed service members, and over half of those who screened positive for psychiatric problems, believe that seeking MH treatments will harm their careers. CONCLUSIONS Despite considerable efforts to destigmatize MH treatment-seeking, a substantial proportion of service members believe that seeking help will negatively impact their careers. On one hand, these perceptions are somewhat backed by reality, as seeking MH treatment is associated with a higher likelihood of being involuntarily discharged. On the other hand, correlational designs cannot establish causality. Variables that increase both treatment-seeking and discharge could include (1) adverse childhood experiences; (2) elevated psychological problems (including both [a] the often-screened depression, anxiety, and posttraumatic stress problems and [b] problems that can interfere with military service: personality disorders, psychotic disorders, and bipolar disorder, among others); (3) a history of aggressive or behavioral problems; and (4) alcohol use and abuse. In addition, most referrals are self-directed and do not result in any career-affecting provider recommendations. In conclusion, the essential question of this research area-"Does seeking MH treatment, compared with not seeking treatment, cause career harm?"-has not been addressed scientifically. At a minimum, longitudinal studies before treatment initiation are required, with multiple data collection waves comprising symptom measurement, treatment, and other services obtained, and a content-valid measure of career impact.
Collapse
Affiliation(s)
- Richard E Heyman
- Family Translational Research Group, New York University, New York, NY 10010, USA
| | - Amy M Smith Slep
- Family Translational Research Group, New York University, New York, NY 10010, USA
| | - Aleja M Parsons
- Family Translational Research Group, New York University, New York, NY 10010, USA
| | - Emma L Ellerbeck
- Family Translational Research Group, New York University, New York, NY 10010, USA
| | - Katharine K McMillan
- Air Force Medical Readiness Agency, United States Air Force (via a contract with Analytical Services and Materials [USA]), JBSA Lackland AFB, TX 78236-1025, USA
| |
Collapse
|
16
|
Resilience to mental health problems and the role of deployment status among U.S. Army Reserve and National Guard Soldiers. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1299-1310. [PMID: 32556425 PMCID: PMC7746625 DOI: 10.1007/s00127-020-01899-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 06/09/2020] [Indexed: 01/19/2023]
Abstract
PURPOSE Research suggests that interpersonal and intrapersonal resiliency factors protect against poor post-deployment mental health outcomes among Reserve/Guard soldiers who have been deployed. There is increasing awareness that never-deployed soldiers are also at risk. The purpose of this study was to examine the relationships between resiliency factors and a range of mental health outcomes among a sample of United States Army Reserve and National Guard (USAR/NG) soldiers who have and have not experienced deployment. METHODS A subset of data was drawn from Operation: SAFETY (N = 360), an ongoing study examining the health and well-being of USAR/NG soldiers. We used a multivariate path analysis approach to examine the simultaneous effects of unit support, marital satisfaction, and psychological hardiness on the following mental health outcomes, concurrently: anger, anxiety, depression, and posttraumatic stress disorder (PTSD) symptomatology. We also examined interaction effects between resiliency factors and deployment status on mental health outcomes. RESULTS Greater unit support (ps < 0.01), marital satisfaction (ps < 0.001), and psychological hardiness (ps < 0.001) were associated with less anger, anxiety, depression, and PTSD symptomatology. Psychological hardiness had significant interactions with deployment status on anxiety, depression, and PTSD, such that the protective effects of psychological hardiness were even stronger among never-deployed soldiers than previously deployed solders. CONCLUSION Resiliency factors can be targeted for intervention to prevent poor mental health outcomes among USAR/NG soldiers, regardless of deployment status. Further, psychological hardiness may be an even more important protective factor among soldiers who have never been deployed.
Collapse
|
17
|
Këllezi B, Wakefield J, Bowe M, Stevenson C, McNamara N. Healthcare provision inside immigration removal centres: A social identity analysis of trust, legitimacy and disengagement. Appl Psychol Health Well Being 2021; 13:578-601. [PMID: 33755329 DOI: 10.1111/aphw.12263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 02/01/2021] [Accepted: 02/08/2021] [Indexed: 01/21/2023]
Abstract
The stressors of immigration detention and negative host country experiences make effective access to health care vital for migrant detainees, but little is known regarding the health experiences of this populations and the barriers to healthcare access. The present research investigates immigration detainees' experiences of health-related help-seeking in the distressing and stigmatised environment of UK immigration removal centres (IRCs), as well as staff members' experiences of providing help. Semi-structured interviews were conducted with 40 detainees and 21 staff and analysed using theoretical thematic analysis guided by the social identity approach. The findings indicate that the practical constraints on help provision (e.g. lack of time and resources, the unpredictable nature of detention) are exacerbated by the complex and conflictual intergroup relationships within which these helping transactions occur. These transactions are negatively affected by stigma, mutual distrust and reputation management concerns, as well as detainees' feelings of powerlessness and confusion around eligibility to receive health care. Some detainees argued that the help ignores the systematic inequalities associated with their detainee status, thereby making it fundamentally inappropriate and ineffective. The intergroup context (of inequality and illegitimacy) shapes the quality of helping transactions, care experiences and health service engagement in groups experiencing chronic low status, distress and uncertainty.
Collapse
Affiliation(s)
- Blerina Këllezi
- Social and Trauma Psychology, School of Psychology, Nottingham Trent University, Nottingham, UK.,Social Psychology, School of Psychology, Nottingham Trent University, Nottingham, UK
| | - Juliet Wakefield
- Social and Trauma Psychology, School of Psychology, Nottingham Trent University, Nottingham, UK.,Social Psychology, School of Psychology, Nottingham Trent University, Nottingham, UK
| | - Mhairi Bowe
- Social and Trauma Psychology, School of Psychology, Nottingham Trent University, Nottingham, UK.,Social Psychology, School of Psychology, Nottingham Trent University, Nottingham, UK
| | - Clifford Stevenson
- Social and Trauma Psychology, School of Psychology, Nottingham Trent University, Nottingham, UK.,Social Psychology, School of Psychology, Nottingham Trent University, Nottingham, UK
| | - Niamh McNamara
- Social and Trauma Psychology, School of Psychology, Nottingham Trent University, Nottingham, UK.,Social Psychology, School of Psychology, Nottingham Trent University, Nottingham, UK
| |
Collapse
|
18
|
Osgood JM, Yates HK, Adler AB, Dyches KD, Quartana PJ. Tired and angry: Sleep, mental health, and workplace relational aggression. MILITARY PSYCHOLOGY 2021. [DOI: 10.1080/08995605.2021.1897490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Jeffrey M. Osgood
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Hunter K. Yates
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Amy B. Adler
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Karmon D. Dyches
- Military Operational Medicine Research Program, U.S. Army Medical Research and Development Command, Frederick, Maryland
| | - Phillip J. Quartana
- Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
| |
Collapse
|
19
|
Christian A, Parekh B, Koritzky G. Bias and discrimination against men with overweight in the military. Health Psychol Open 2021; 7:2055102920985374. [PMID: 33489302 PMCID: PMC7768582 DOI: 10.1177/2055102920985374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Research on weight-bias against men and/or in the military is scarce. Such a bias might cause some military members, who are otherwise fit to perform their duties, to suffer from discrimination and undue stress. We showed military personnel a picture of a soldier who had either normal weight or overweight. In both conditions, the description of the soldier stated that his physical fitness and job-related skills were good. Nonetheless, the soldier’s suitability for promotion was rated lower in the overweight condition. These findings improve our understanding of the impact of bias on the mental and physical health of men with overweight.
Collapse
Affiliation(s)
| | - Bina Parekh
- The Chicago School of Professional Psychology, USA
| | | |
Collapse
|
20
|
Sayers SL, Hess TH, Whitted P, Straits-Tröster KA, Glynn SM. Coaching Into Care: Veterans Affairs Telephone-Based Service for Concerned Family Members of Military Veterans. Psychiatr Serv 2021; 72:107-109. [PMID: 33167815 DOI: 10.1176/appi.ps.201900113] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Many veterans who need mental health treatment are reluctant to seek care, and their family members often do not know how to encourage them to do so. In 2011, a telephone-based service called Coaching Into Care (CIC) was developed to address this concern. Callers are provided with educational resources and referrals; in more complicated cases, callers are provided with up to 6 months of telephone-based coaching. This coaching of family members has been associated with an increase in veterans accessing mental health care. This program may serve as a model for community efforts to engage individuals in needed mental health care.
Collapse
Affiliation(s)
- Steven L Sayers
- Department of Psychiatry, University of Pennsylvania, and Corporal Michael J. Crescenz Veterans Affairs (VA) Medical Center, Philadelphia (Sayers, Hess); Durham VA Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina (Whitted, Straits-Tröster); VA Office of Mental Health and Suicide Prevention, and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (Glynn). Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column
| | - Tanya H Hess
- Department of Psychiatry, University of Pennsylvania, and Corporal Michael J. Crescenz Veterans Affairs (VA) Medical Center, Philadelphia (Sayers, Hess); Durham VA Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina (Whitted, Straits-Tröster); VA Office of Mental Health and Suicide Prevention, and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (Glynn). Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column
| | - Perry Whitted
- Department of Psychiatry, University of Pennsylvania, and Corporal Michael J. Crescenz Veterans Affairs (VA) Medical Center, Philadelphia (Sayers, Hess); Durham VA Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina (Whitted, Straits-Tröster); VA Office of Mental Health and Suicide Prevention, and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (Glynn). Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column
| | - Kristy A Straits-Tröster
- Department of Psychiatry, University of Pennsylvania, and Corporal Michael J. Crescenz Veterans Affairs (VA) Medical Center, Philadelphia (Sayers, Hess); Durham VA Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina (Whitted, Straits-Tröster); VA Office of Mental Health and Suicide Prevention, and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (Glynn). Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column
| | - Shirley M Glynn
- Department of Psychiatry, University of Pennsylvania, and Corporal Michael J. Crescenz Veterans Affairs (VA) Medical Center, Philadelphia (Sayers, Hess); Durham VA Medical Center, and Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina (Whitted, Straits-Tröster); VA Office of Mental Health and Suicide Prevention, and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles (Glynn). Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column
| |
Collapse
|
21
|
Millegan J, Lippy R, De La Rosa G, Swayze M, Murray T, Hucles K, Webb-Murphy J, Bhakta J, Delaney E, Pauli I, Buenviaje B. Workforce Planning for Embedded Mental Health Care in the U.S. Navy. Mil Med 2020; 185:e1961-e1967. [PMID: 32754734 DOI: 10.1093/milmed/usaa195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/08/2020] [Accepted: 07/01/2020] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Embedding mental health providers directly into operational units provides opportunities for holistic individual and population focused mental health support. To effectively provide clinical mental health care to a large number of Sailors and Marines while supporting the larger command, it is crucial to arrive at an optimal number of mental health (MH) care staff. In response to an increasing demand for MH care by operational units distributed globally, the U.S. Navy (USN) critically analyzed the current MH staffing levels, estimated future demand for MH care providers, and evaluated several staffing options. The following article illustrates a case study of workforce planning for the USN's embedded MH delivery model. MATERIALS AND METHODS Several existing data sources were used to calculate current number of MH care staff across all USN platforms and to estimate demand for MH care. An open source Linear Programming application was used to estimate staffing solutions that meet business requirements in the most efficient manner possible. RESULTS Results suggested different conclusions for embedded mental health staffing across USN communities. Depending on existing staffing levels and the number of Sailors or Marines anticipated to require care, the Linear Programming algorithm estimated needed staffing levels to address demand. CONCLUSION The current project represents the first systematic workforce planning initiative designed to help staff the USN's global demand for community focused MH care. The results of this project have identified areas where additional embedded mental health resources should be made available. By systematically documenting all services and capabilities and carefully examining the operational demands of each community, the current solution was able to identify precisely what type of MH resources should be allocated to a given community.
Collapse
Affiliation(s)
- Jeffrey Millegan
- Naval Center for Combat and Operational Stress Control, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134
| | - Robert Lippy
- Naval Center for Combat and Operational Stress Control, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134
| | - Gabriel De La Rosa
- Naval Center for Combat and Operational Stress Control, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134
| | - Michael Swayze
- United States Army Budget Office, 110 Army Pentagon, Washington, DC 20310-0110
| | - Thomas Murray
- US Navy Bureau of Medicine and Surgery, 7700 Arlington Blvd, Falls Church, VA 22042
| | - Katherine Hucles
- Navy Marine Corps Public Health Center, 620 John Paul Jones Cir #1100, Portsmouth, VA 23704
| | - Jennifer Webb-Murphy
- Naval Center for Combat and Operational Stress Control, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134
| | - Jagruti Bhakta
- Naval Center for Combat and Operational Stress Control, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134
| | - Eileen Delaney
- Naval Center for Combat and Operational Stress Control, 34960 Bob Wilson Drive, Suite 400, San Diego, CA 92134
| | - Ingrid Pauli
- US Navy Bureau of Medicine and Surgery, 7700 Arlington Blvd, Falls Church, VA 22042
| | | |
Collapse
|
22
|
Geuzinge R, Visse M, Duyndam J, Vermetten E. Social Embeddedness of Firefighters, Paramedics, Specialized Nurses, Police Officers, and Military Personnel: Systematic Review in Relation to the Risk of Traumatization. Front Psychiatry 2020; 11:496663. [PMID: 33408646 PMCID: PMC7779596 DOI: 10.3389/fpsyt.2020.496663] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 11/20/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Firefighters, paramedics, specialized nurses working in Intensive Care Units (ICUs), Operating Rooms (OR), and Emergency Rooms (ER), police officers and military personnel are more frequently exposed to potentially traumatic events than the general population; they are considered high-risk professionals. To reduce the risk of traumatization it is of great importance to be embedded in a social environment with supportive relationships. Methods: We performed a systematic review (based on the PRISMA-Guidelines) looking for social connections within the environment in which high-risk professionals are embedded (work, home, community), to obtain evidence on the impact of these connections on the risk of traumatization. Additionally, we aim to identify relevant supportive relationships in the professionals' environments. We identified the relevant scientific literature by searching, without time, and language restriction, five electronic bibliographic databases: MEDLINE, PsycINFO, Sociological Abstracts, CINAHL, and Web of Science. These databases were last searched in January 2019. Results: A qualitative analysis of the 89 eligible (out of 9,047 screened) studies shows that for firefighters, paramedics, and emergency nurses social connections in their work environment are predominantly supportive relationships and may protect them against traumatization. In other occupations (OR-nurses, ICU-nurses, police officers), however, social connections at work are not only a source of support but are also a source of stress. For military personnel study results are inconclusive as to whether their social connections at work or at home support them against traumatization. In so far as connections are supportive, their sources vary greatly from one occupational group to another; they differ between work vs. home as well as within work between peers vs. supervisor. Conclusions: Being embedded in a social environment, i.e., having social connections, is important but not always sufficient to protect high-risk professionals against traumatization. For, while these connections may be the antecedents of supportive relationships, they can also be the antecedents of damaging relationships. Additionally, the sources of supportive relationships differ among groups. This suggests that knowledge of how the social structures of the occupational groups differ may increase our understanding of the impact of social connections and relationships, including socialization, on the risk of traumatization of high-risk professionals.
Collapse
Affiliation(s)
- Renate Geuzinge
- Humanism and Social Resilience, University of Humanistic Studies, Utrecht, Netherlands
| | - Merel Visse
- Care Ethics, University of Humanistic Studies, Utrecht, Netherlands
| | - Joachim Duyndam
- Humanism and Social Resilience, University of Humanistic Studies, Utrecht, Netherlands
| | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
- Ministry of Defense, Military Mental Health Research Center, Utrecht, Netherlands
- ARQ National Psychotrauma Center, Diemen, Netherlands
| |
Collapse
|
23
|
Wan Mohd Yunus WMA, Musiat P, Brown JSL. Innovative Self-Confidence Webinar Intervention for Depression in the Workplace: A Focus Group Study and Systematic Development. Behav Sci (Basel) 2020; 10:bs10120193. [PMID: 33339086 PMCID: PMC7765479 DOI: 10.3390/bs10120193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022] Open
Abstract
Brief face-to-face self-confidence workshops were effective in reducing depression among the public. Technological advances have enabled traditional face-to-face interventions to be adapted using unique technology-mediated platforms. This article details the formative development of a self-confidence web-based seminar (webinar) intervention for workplace depression. The first section discusses a qualitative study that explores the feasibility and acceptability of adapting the self-confidence workshops into a webinar platform on employees in the workplace. The second section describes the systematic development of this new webinar intervention informed by the qualitative study findings, a published systematic review, and previous face-to-face self-confidence workshops. The qualitative study involves three focus groups (n = 10) conducted in a small organization. Three themes were identified relevant to the running of the new self-confidence webinars in the workplace: personal (content, time and duration preference, features of the webinar, individual participation, personalization), interpersonal (stigma from others, engagement with participants/presenter, moderated interaction), and organizational (endorsement from management, work demand). For the intervention development, the format, structure, features, and content of the self-confidence webinar intervention are described. Features such as file sharing, virtual whiteboard, live chat, and poll are explained with the intervention primarily based on cognitive behavior therapy and coping flexibility concepts.
Collapse
Affiliation(s)
- Wan Mohd Azam Wan Mohd Yunus
- Research Centre for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori 3. floor, 20014 Turku, Finland
- Department of Psychology, School of Human Resource Development and Psychology, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Skudai 81310, Malaysia
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE5 8AF, UK;
- Correspondence:
| | - Peter Musiat
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE5 8AF, UK;
| | - June S. L. Brown
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London SE5 8AF, UK;
| |
Collapse
|
24
|
Qualitative Study of NAMI Homefront Family Support Program. Community Ment Health J 2020; 56:1391-1405. [PMID: 32193852 DOI: 10.1007/s10597-020-00582-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 02/11/2020] [Indexed: 10/24/2022]
Abstract
The National Alliance on Mental Illness's Homefront program is a 6-week peer-taught program for family members of veterans and active duty soldiers. Homefront is associated with increased empowerment, coping, and knowledge, but little is known about member experiences. This study used telephone interviews to identify program components that are helpful or need improvement, and to compare the online and in-person program formats. Seventeen participants (7 online) and 17 instructors (3 online) were interviewed and qualitative data analysis suggested that the most helpful components were group discussion, lessons on veteran-specific issues, and coping skills workshops. Some suggested expanding Homefront to 8 or 10 weeks. The online program was convenient for those unable to attend otherwise, but participants cited some dissatisfaction with the discussion format. Instructors described teaching the program as rewarding and noted learning from the curriculum. Understanding the experiences of participants may inform the development of future psychoeducation programs.
Collapse
|
25
|
Vest BM, Kulak JA, Homish DL, Hoopsick RA, Homish GG. Mental and physical health factors related to dual use of veterans affairs and non-veterans affairs healthcare among U.S. reserve soldiers. PSYCHOL HEALTH MED 2020; 27:976-986. [PMID: 32997548 DOI: 10.1080/13548506.2020.1828945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study examined the association between mental and physical health factors and dual use of Veterans' Affairs (VA) and non-VA healthcare among previously deployed male Reserve/National Guard (R/NG) soldiers (N = 214). Participants completed online annual surveys on a range of topics, including validated measures of mental and physical health, as well as questions about past-year healthcare utilization. Multinomial logistic regression models separately examined the association between mental health symptoms (PTSD, anxiety, depression, emotional role limitations), physical health symptoms (bodily pain, physical role limitations), and healthcare use (single use and dual use compared to no use), controlling for geography, trust in the VA, age, and race. Anxiety (aRR: 1.13; 95% Confidence Interval (CI): 1.02, 1.26; p<.05), depression (aRR: 1.23; 95% CI: 1.06, 1.43; p<.01), and PTSD (aRR: 1.05; 95% CI: 1.01, 1.10; p<.05) symptoms were all related to past year dual use of VA and non-VA healthcare, even after controlling for known demographic factors. Bodily pain and emotional and physical role limitations were not related to healthcare outcomes. This suggests that mental health symptoms themselves may be a primary factor driving healthcare use. Further study is needed to examine whether dual use of VA and non-VA healthcare is duplicative or complementary.
Collapse
Affiliation(s)
- Bonnie M Vest
- Department of Family Medicine, University at Buffalo, Buffalo, NY, USA
| | - Jessica A Kulak
- Department of Health, Nutrition, & Dietetics, Buffalo State College, Buffalo, NY, USA
| | - D Lynn Homish
- Department of Community Health & Health Behavior, University at Buffalo, Buffalo, NY, USA
| | - Rachel A Hoopsick
- Department of Family Medicine, University at Buffalo, Buffalo, NY, USA.,Department of Community Health & Health Behavior, University at Buffalo, Buffalo, NY, USA
| | - Gregory G Homish
- Department of Community Health & Health Behavior, University at Buffalo, Buffalo, NY, USA
| |
Collapse
|
26
|
Thériault FL, Gardner W, Momoli F, Garber BG, Kingsbury M, Clayborne Z, Cousineau-Short DY, Sampasa-Kanyinga H, Landry H, Colman I. Mental Health Service Use in Depressed Military Personnel: A Systematic Review. Mil Med 2020; 185:e1255-e1262. [PMID: 32073617 DOI: 10.1093/milmed/usaa015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/23/2019] [Accepted: 05/22/2019] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Major depression is a leading cause of morbidity in military personnel and an important impediment to operational readiness in military organizations. Although treatment options are available, a large proportion of individuals with depression do not access mental health services. Quantifying and closing this treatment gap is a public health priority. However, the scientific literature on the major depression treatment gap in military organizations has never been systematically reviewed. METHODS We systematically searched the EMBASE, MEDLINE, and PsychINFO databases for studies measuring recent mental health service use in personnel serving in the armed forces of a Five-Eye country (Australia, Canada, New Zealand, the United Kingdom, or the United States). We excluded studies conducted with retired veterans. Because of the substantial heterogeneity in included studies, we did not pool their results. Instead, we computed median period prevalence of mental health service use. RESULTS Twenty-eight studies were included in the systematic review; 12 had estimated mental health service use in personnel with depression, and another 16 had estimated mental health service use in personnel with depression or another mental health disorder. The period prevalence of mental health service use in depressed military personnel ranged from 20 to 75% in 12 included studies, with a median of 48%, over 2-12 months. The other 16 studies yielded similar conclusions; they reported period prevalence of mental health service use in personnel with any mental health disorder ranging from 14 to 75%, with a median of 36%, over 1-12 months. The median was higher in studies relying on diagnostic interviews to identify depressed personnel, compared to studies relying on screening tools (60% vs. 44%). CONCLUSIONS There is a large treatment gap for major depression in particular, and for mental health disorders in general, among military personnel. However, our results highlight the association between the use of measurement tools and treatment gaps: estimated treatment gaps were larger when depressed patients were identified by screening tools instead of diagnostic interviews. Researchers should be wary of overestimating the mental health treatment gap when using screening tools in future studies.
Collapse
Affiliation(s)
- François L Thériault
- School of Epidemiology & Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON,K1G 5Z3, Canada.,Canadian Forces Health Services Group, Department of National Defence, National Defence HQ (Carling), 60 Moodie Drive, Ottawa, ON K1A 0K2, Canada
| | - William Gardner
- School of Epidemiology & Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON,K1G 5Z3, Canada.,CHEO Research Institute, Children Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Franco Momoli
- School of Epidemiology & Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON,K1G 5Z3, Canada.,CHEO Research Institute, Children Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada.,Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada
| | - Bryan G Garber
- School of Epidemiology & Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON,K1G 5Z3, Canada.,Canadian Forces Health Services Group, Department of National Defence, National Defence HQ (Carling), 60 Moodie Drive, Ottawa, ON K1A 0K2, Canada
| | - Mila Kingsbury
- School of Epidemiology & Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON,K1G 5Z3, Canada
| | - Zahra Clayborne
- School of Epidemiology & Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON,K1G 5Z3, Canada
| | - Daniel Y Cousineau-Short
- Canadian Forces Health Services Group, Department of National Defence, National Defence HQ (Carling), 60 Moodie Drive, Ottawa, ON K1A 0K2, Canada.,Department of Health Sciences, Carleton University, 2305 Health Sciences Building, 1125 Colonel By Drive, Ottawa, ON K1S 5B6, Canada
| | - Hugues Sampasa-Kanyinga
- School of Epidemiology & Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON,K1G 5Z3, Canada
| | - Hannah Landry
- School of Epidemiology & Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON,K1G 5Z3, Canada
| | - Ian Colman
- Centre for Fertility and Health, Norwegian Institute of Public Health, Postbox 222 Skøyen, N-0213 Oslo, Norway
| |
Collapse
|
27
|
Britt TW, Sipos ML, Klinefelter Z, Adler AB. Determinants of mental and physical health treatment-seeking among military personnel. Br J Psychiatry 2020; 217:420-426. [PMID: 31258095 DOI: 10.1192/bjp.2019.155] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Although research has documented factors influencing whether military personnel seek treatment for mental health problems, less research has focused on determinants of treatment-seeking for physical health problems. AIMS To explicitly compare the barriers and facilitators of treatment-seeking for mental and physical health problems. METHOD US soldiers (n = 2048) completed a survey with measures of barriers and facilitators of treatment-seeking for mental and physical health problems as well as measures of somatic symptoms and mental health. RESULTS The top barrier for both mental and physical health treatment-seeking was a preference for handling problems oneself. The top facilitators for both symptom types were related to treatment improving quality of life. Differential endorsement of barriers occurred for treatment of mental versus physical health symptoms. In contrast, facilitators were endorsed more for physical than for mental health treatment. While there were few gender differences, officers reported more barriers and facilitators than did enlisted personnel. Screening positive for mental or physical health problems was associated with greater endorsement of both barriers and facilitators for physical and mental health treatment, respectively. CONCLUSIONS The leading barriers and facilitators for seeking treatment for mental health and physical problems are relatively similar, suggesting that health education should consider decision-making in seeking both mental and physical healthcare. Interventions should be tailored to reduce barriers for officers and improve facilitators for junior enlisted personnel, and address barriers and facilitators for service members screening positive for a mental or physical health problem.
Collapse
Affiliation(s)
- Thomas W Britt
- Professor, Department of Psychology, Clemson University; and Research Psychologist, Center for Military Psychiatry and Neuroscience Research, Walter Reed Army Institute of Research, USA
| | | | - Zachary Klinefelter
- Graduate Research Assistant, Department of Psychology, Clemson University, USA
| | - Amy B Adler
- Clinical Research Psychologist, Center for Military Psychiatry and Neuroscience Research, Walter Reed Army Institute of Research, USA
| |
Collapse
|
28
|
Rodriguez KE, LaFollette MR, Hediger K, Ogata N, O’Haire ME. Defining the PTSD Service Dog Intervention: Perceived Importance, Usage, and Symptom Specificity of Psychiatric Service Dogs for Military Veterans. Front Psychol 2020; 11:1638. [PMID: 32849004 PMCID: PMC7396623 DOI: 10.3389/fpsyg.2020.01638] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 06/16/2020] [Indexed: 12/28/2022] Open
Abstract
Research suggests that psychiatric service dogs may be an effective complementary treatment option for military veterans with posttraumatic stress disorder (PTSD). Although this practice continues to increase in popularity and research has reached the rigor of clinical trials, the components of the PTSD service dog intervention remain largely undefined. This research aimed to (1) quantify the importance, usage, and PTSD symptom specificity of service dog trained and untrained behaviors, (2) explore how PTSD severity, time since receiving the service dog, and the veteran-dog relationship relate to outcomes, and (3) compare expectations of veterans on the waitlist to experiences of veterans with service dogs. In a cross-sectional design, 217 post-9/11 military veterans with PTSD were recruited from a national service dog provider, including n = 134 with a service dog and n = 83 on the waitlist. Results showed that the service dog's trained tasks of calming and interrupting anxiety were perceived as the most important for veterans' PTSD, the most frequently used in a typical day, and as helping the most PTSD symptoms. Trained tasks were most helpful to the PTSD symptoms of hypervigilance and intrusion, and least helpful toward the symptoms of amnesia and risk-taking. Although all trained tasks were helpful toward PTSD symptoms, veterans rated the service dog's untrained behaviors on average as more important for their PTSD. After controlling for covariates, there was no relationship between a veteran's PTSD severity and perceived importance or frequency of task use. However, veterans who reported feeling closer to their service dogs reported using trained tasks more often, and veterans who had their service dogs for longer reported using trained tasks less often. Finally, veterans on the waitlist reported higher expectations regarding task use and importance than described by veterans with a service dog. In conclusion, findings describe the core components of the PTSD service dog intervention by quantifying the use and value of trained and untrained dog behaviors. Overall, this study helps explain the PTSD service dog's clinically relevant value while contributing to the scientific understanding of this emerging practice.
Collapse
Affiliation(s)
- Kerri E. Rodriguez
- Center for the Human-Animal Bond, Purdue University, West Lafayette, IN, United States
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, United States
| | - Megan R. LaFollette
- Center for the Human-Animal Bond, Purdue University, West Lafayette, IN, United States
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, United States
- Department of Animal Sciences, College of Agriculture, Purdue University, West Lafayette, IN, United States
| | - Karin Hediger
- Department of Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland
| | - Niwako Ogata
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, United States
| | - Marguerite E. O’Haire
- Center for the Human-Animal Bond, Purdue University, West Lafayette, IN, United States
- Department of Comparative Pathobiology, Purdue University, West Lafayette, IN, United States
| |
Collapse
|
29
|
Reger GM, Bourassa K, Norr AM, Buck B. The impact of exposure therapy on stigma and mental health treatment attitudes among active duty U.S. soldiers with combat related PTSD. J Psychiatr Res 2020; 126:98-104. [PMID: 32442781 DOI: 10.1016/j.jpsychires.2020.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 05/04/2020] [Accepted: 05/07/2020] [Indexed: 11/25/2022]
Abstract
Although cognitive behavioral interventions improve attitudes toward mental health treatment and reduce stigma, little is known about which types of attitudes change, or how this change occurs. Active duty soldiers with PTSD (N = 162) were randomized to 10 sessions of exposure therapy or a waitlist. Soldiers were assessed for PTSD and completed measures of stigma and attitudes towards mental health services before randomization and after 5- and 10- sessions of therapy. At post-treatment, soldiers in exposure therapy demonstrated significant improvements in openness to talking about mental health problems and concerns about what others may think if they knew they were seeking mental health treatment, relative to those in the waitlist. There were significant indirect effects from treatment to changes in stigma and attitudes towards mental health treatment through changes in PTSD symptoms at post-treatment. There was also a significant indirect effect from treatment to changes in stigma at post-treatment through changes in attitudes towards mental health treatment at mid-treatment, suggesting attitude change may occur first. Baseline characteristics did not moderate treatment's change in stigma or attitudes. Improvements in PTSD symptoms and positive changes in attitudes towards mental health treatment appear to separately predict later reductions in stigma.
Collapse
Affiliation(s)
- Greg M Reger
- VA Puget Sound Health Care System, 9600 Veterans Drive, A-116, Tacoma, WA, 98493, United States; University of Washington School of Medicine, 1959 NE Pacific St, Box 356560, Seattle, WA, 98195-6560, United States.
| | - Kyle Bourassa
- VA Puget Sound Health Care System, 9600 Veterans Drive, A-116, Tacoma, WA, 98493, United States; Duke University Medical Center, Center for Aging and Human Development, 2020 W. Main St., Durham, NC, 27707, United States
| | - Aaron M Norr
- VISN 20 Northwest Network Mental Illness Research, Education and Clinical Center (MIRECC), 1660 S. Columbian Way, Seattle, WA, 98108, United States; University of Washington School of Medicine, 1959 NE Pacific St, Box 356560, Seattle, WA, 98195-6560, United States
| | - Benjamin Buck
- VA Puget Sound Health Care System, 9600 Veterans Drive, A-116, Tacoma, WA, 98493, United States; University of Washington School of Medicine, 1959 NE Pacific St, Box 356560, Seattle, WA, 98195-6560, United States
| |
Collapse
|
30
|
Vaudreuil R, Langston DG, Magee WL, Betts D, Kass S, Levy C. Implementing music therapy through telehealth: considerations for military populations. Disabil Rehabil Assist Technol 2020; 17:201-210. [PMID: 32608282 DOI: 10.1080/17483107.2020.1775312] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Telehealth provides psychotherapeutic interventions and psychoeducation for remote populations with limited access to in-person behavioural health and/or rehabilitation treatment. The United States Department of Défense and the Veterans Health Administration use telehealth to deliver primary care, medication management, and services including physical, occupational, and speech-language therapies for service members, veterans, and eligible dependents. While creative arts therapies are included in telehealth programming, the existing evidence base focuses on art therapy and dance/movement therapy, with a paucity of information on music therapy. METHODS Discussion of didactic and applied music experiences, clinical, ethical, and technological considerations, and research pertaining to music therapy telehealth addresses this gap through presentation of three case examples. These programmes highlight music therapy telehealth with military-connected populations on a continuum of clinical and community engagement: 1) collaboration between Berklee College of Music in Boston, MA and the Acoke Rural Development Initiative in Lira, Uganda; 2) the Semper Sound Cyber Health programme in San Diego, CA; and 3) the integration of music therapy telehealth into Creative Forces®, an initiative of the National Endowment for the Arts. RESULTS These examples illustrate that participants were found to positively respond to music therapy and community music engagement through telehealth, and reported decrease in pain, anxiety, and depression; they endorsed that telehealth was not a deterrent to continued music engagement, requested continued music therapy telehealth sessions, and recommended it to their peers. CONCLUSIONS Knowledge gaps and evolving models of creative arts therapies telehealth for military-connected populations are elucidated, with emphasis on clinical and ethical considerations.IMPLICATIONS FOR REHABILITATIONMusic therapy intervention can be successfully adapted to accommodate remote facilitation.Music therapy telehealth has yielded positive participant responses including decrease in pain, anxiety, and depression.Telehealth facilitation is not a deterrent to continued music engagement.Distance delivery of music through digital platforms can support participants on a clinic to community continuum.
Collapse
Affiliation(s)
- Rebecca Vaudreuil
- Creative Forces-NEA Military Healing Arts Network, National Endowment for the Arts, Washington, DC, USA
| | - Diane G Langston
- Creative Forces-NEA Military Healing Arts Network, National Endowment for the Arts, Washington, DC, USA.,Physical Medicine and Rehabilitation, Malcom Randall VA Hospital, Gainesville, FL, USA
| | - Wendy L Magee
- Boyer College of Music and Dance, Temple University, Philadelphia, PA, USA
| | - Donna Betts
- Creative Forces-NEA Military Healing Arts Network, National Endowment for the Arts, Washington, DC, USA
| | - Sara Kass
- Creative Forces-NEA Military Healing Arts Network, National Endowment for the Arts, Washington, DC, USA
| | - Charles Levy
- Physical Medicine and Rehabilitation, Malcom Randall VA Hospital, Gainesville, FL, USA
| |
Collapse
|
31
|
Nugent KL, Riviere LA, Sipos ML, Wilk JE. Mental Health Service Utilization and Perceived Barriers to Receiving Care in Deployed Soldiers. Mil Med 2020; 185:e625-e631. [PMID: 32175578 DOI: 10.1093/milmed/usaa019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Scant research has examined mental health treatment utilization and barriers to care in deployed U.S. soldiers. This study aims to assess mental health treatment utilization in deployed soldiers, including providers used and barriers to care. MATERIALS AND METHODS U.S. Army soldiers (n = 2,412) in a combat environment were surveyed on psychiatric symptoms, mental health help received, sources of care, and perceived barriers to care by Mental Health Advisory teams from 2009 to 2013. RESULTS Of the 25% of soldiers at mental health risk, 37% received mental health help, with 18% receiving help from a provider. Nonprovider sources of care were utilized significantly more frequently than providers. Soldiers at mental health risk reported significantly greater anticipated career-related stigma, organizational barriers to care, self-reliance views, and negative attitudes toward care, yet these constructs did not differ between who did or did not receive help. Soldiers who received help from providers exclusively reported significantly more anticipated career-related stigma and fewer organizational barriers to care than those that received no help. Soldiers who spent no time living outside the forward operating base and soldiers with six or more types of combat exposures were more likely to receive help. CONCLUSIONS Prevalence of common psychopathology and receipt of care in a combat environment was similar to previous reports from postdeployment settings. Nonprovider sources of care were more frequently utilized as compared to an in-Garrison report. Findings suggest important differences exist in sources of help and barriers to care in deployed vs. postdeployment environments. The hypothesized barriers to care did not preclude receiving any help, however, less than one-half of soldiers at mental health risk received help. Thus, future research should identify factors that have the greatest influence on help seeking behavior in both deployed and Garrison settings.
Collapse
Affiliation(s)
- Katie L Nugent
- TechWerks, 2001 Clarendon Blvd, Suite 705, Arlington, VA 22201.,Military Psychiatry Branch, Center for Military Psychiatry and Neurosciences, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD 20906
| | - Lyndon A Riviere
- Military Psychiatry Branch, Center for Military Psychiatry and Neurosciences, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD 20906
| | - Maurice L Sipos
- Command and Leadership Studies, Department of Command, Leadership and Management, US Army War College, 122 Forbes Ave, Carlisle, PA 17013
| | - Joshua E Wilk
- Military Psychiatry Branch, Center for Military Psychiatry and Neurosciences, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD 20906
| |
Collapse
|
32
|
Bradley SE, Haun J, Powell-Cope G, Haire S, Belanger HG. Qualitative assessment of the use of a smart phone application to manage post-concussion symptoms in Veterans with traumatic brain injury. Brain Inj 2020; 34:1031-1038. [DOI: 10.1080/02699052.2020.1771770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Sarah E. Bradley
- Research Service, James A. Haley Veterans’ Hospital, Tampa, Florida, USA
| | - Jolie Haun
- Research Service, James A. Haley Veterans’ Hospital, Tampa, Florida, USA
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Gail Powell-Cope
- Research Service, James A. Haley Veterans’ Hospital, Tampa, Florida, USA
| | - Sharon Haire
- Research Service, James A. Haley Veterans’ Hospital, Tampa, Florida, USA
| | - Heather G. Belanger
- Defense and Veterans Brain Injury Center (DVBIC), United States Special Operations Command, Tampa, Florida, USA
- Departments of Psychology, and Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, Florida, USA
| |
Collapse
|
33
|
Adler A, Jager-Hyman S, Brown GK, Singh T, Chaudhury S, Ghahramanlou-Holloway M, Stanley B. A Qualitative Investigation of Barriers to Seeking Treatment for Suicidal Thoughts and Behaviors Among Army Soldiers with a Deployment History. Arch Suicide Res 2020; 24:251-268. [PMID: 31237808 DOI: 10.1080/13811118.2019.1624666] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study aimed to identify barriers to treatment seeking and service utilization among previously deployed Army soldiers who recently experienced a suicidal crisis. Confidential interviews were conducted on a psychiatric inpatient unit with 12 Army soldiers with a deployment history following a suicidal crisis. Qualitative analysis focused on statements coded as "barriers to seeking help" and "explicit recommendations." Suicidal Army soldiers with a deployment history experienced different barriers to seeking help, including stigma and logistical challenges (e.g., long wait times for appointments). Negative and positive perceptions of support were reported for various resources - for example, family, crisis hotlines, chaplains, and command. Suicidal Army soldiers, interviewed in this study, experienced a number of challenges and frustrations associated with various helping resources. This study highlights the need for greater attention toward understanding these challenges and subsequently addressing them through appropriate resource allocation and additional training for those working directly with Army soldiers at risk for suicide.
Collapse
|
34
|
Rao VA, Bechtold KT, Arciniegas DB, Samus QM, Albrecht J, Pugh BT, Jacoby A, Buenaver L. Establishment of a Patient-Centered Outcomes Research Network for Individuals with TBI and Neuropsychiatric Symptoms. Brain Inj 2020; 34:548-555. [PMID: 32050805 DOI: 10.1080/02699052.2020.1725980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Aims: The overarching goal of this project was to establish a group comprised of a variety of TBI stakeholders for the purpose of: (1) determining facilitators and barriers in management of neuropsychiatric symptoms after TBI; (2) identifying strategies for maintaining a TBI PCOR network; (3) enumerating research topics related to TBI neuropsychiatry; and (4) highlighting policy changes related to TBI neuropsychiatry.Methods: Twenty-nine TBI stakeholders participated in focus group discussions. Qualitative analyses were conducted both manually and using Dedoose software.Results: Participant-identified barriers included stigma associated with experiencing neuropsychiatric symptoms and poor insurance coverage. Facilitators included treatment focused on education of neuropsychiatric symptoms after TBI and having a comprehensive caregiver plan. Best strategies for maintaining TBI PCOR network included having a well-defined project, continued regular meetings, and on-going education of network members. Pertinent research topics included TBI and aging, factors influencing outcomes after TBI, substance use disorders related to TBI, and effectiveness of telemental health services. Needed policy changes included making TBI neuropsychiatry education accessible to stakeholders and improving accessibility of TBI neuropsychiatric care.Conclusion: TBI stakeholders identified several facilitators of care for neuropsychiatric symptoms after TBI and suggested research topics and best practices for conducting PCOR in this area.
Collapse
Affiliation(s)
- Vani A Rao
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Kathleen T Bechtold
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, USA
| | - David B Arciniegas
- Marcus Institute for Brain Health, University of Colorado School of Medicine, Baltimore, USA
| | - Quincy M Samus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Jennifer Albrecht
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, USA
| | - Bryan T Pugh
- Brain Injury Association of Maryland, Baltimore, USA
| | - Aaron Jacoby
- VA Maryland Health Care System, University of Maryland School of Medicine, Baltimore, USA
| | - Luis Buenaver
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, USA
| |
Collapse
|
35
|
C'de Baca J, Castillo D, DeBeer B, Qualls C. Rationale and design of an efficacy study of Group Prolonged Exposure for PTSD. Contemp Clin Trials Commun 2020; 17:100509. [PMID: 31989057 PMCID: PMC6970140 DOI: 10.1016/j.conctc.2019.100509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 11/27/2019] [Accepted: 12/12/2019] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Among health problems in the Veteran population, the most common is posttraumatic stress disorder (PTSD) and its effect on the quality of life. Prolonged Exposure therapy, based on emotional processing theory, is a first-line treatment for reducing PTSD symptom severity when delivered in an individual format, and its efficacy is well established. The primary objective of this study is to establish the efficacy of prolonged exposure delivered in a small 3-person group modality. Quality of life should improve with decreases in PTSD symptoms such as sleep disturbance, irritability, and hypervigilance. Stigma is associated with hesitation in seeking treatment and treatment dropout. A secondary objective is to measure the effect of group treatment on reducing the stigma surrounding PTSD. METHODS/DESIGN This study is a randomized controlled trial testing the efficacy of Group Prolonged Exposure (PE) for reducing PTSD symptom severity and improving quality of life in male Afghanistan and Iraq Veterans. All participants are randomly assigned to receive Group PE or Group Present-Centered Therapy (PCT) for 10-weekly, 90-min sessions. Group PE focuses on processing trauma memories, while the goal of Group PCT is improved psychosocial functioning through management of current stressors. The primary outcome is improvement in CAPS-5 PTSD symptom severity scores and quality of life measures (WHO-QOL and SF-36) from pre-treatment to post-treatment, 3-months post-treatment, and 6-months post-treatment. A secondary outcome is reductions in perceived self-stigma of mental illness based on the Stigma Scale at baseline and follow-up points. This study is designed to expand access to this first-line treatment for PTSD by delivering PE in a small group modality while conforming to the individual PE protocol, with group treatment reducing perceived stigma of mental illness.
Collapse
Affiliation(s)
- Janet C'de Baca
- New Mexico VA Health Care System VISN 22, Behavioral Health Care Line (116), 1501 San Pedro SE, Albuquerque, NM, 87108, USA
| | - Diane Castillo
- VA VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Memorial Drive, 151-C, Waco, TX, 76711, USA
| | - Bryann DeBeer
- VA VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Memorial Drive, 151-C, Waco, TX, 76711, USA.,Texas A&M University Health Science Center, Temple, TX, USA
| | - Clifford Qualls
- Mathematics and Statistics, University of New Mexico, Albuquerque, NM, USA.,Biostatistician, Biomedical Research Institute of New Mexico, Albuquerque, NM, USA
| |
Collapse
|
36
|
Beidel DC, Neer SM, Bowers CA, Newins AR, Tuerk PW, Cunningham CA, Mooney SR, Hauck HN, Jett M. Trauma Management Therapy and Prolonged Exposure Therapy for PTSD in an active duty sample: Design and methodology of a randomized clinical trial. Contemp Clin Trials Commun 2019; 17:100491. [PMID: 31799476 PMCID: PMC6881668 DOI: 10.1016/j.conctc.2019.100491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 11/04/2019] [Accepted: 11/09/2019] [Indexed: 11/30/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) resulting from military service is a common, yet often chronic condition. Treatment outcome often is attenuated by programs that are (a) lengthy in nature and (b) constricted in their target outcomes. These limitations leave much of the emotional and behavioral impairment that accompanies PTSD unaddressed and/or unassessed. Typical PTSD treatment programs are 3–4 months in length, which is challenging for the pace of the nation's military. In this investigation, we will compare two treatments, Trauma Management Therapy (TMT) and Prolonged Exposure (PE), both redesigned to address the needs of active duty personnel (300 participants at 3 military installations). Specifically, we will compare the TMT Intensive Outpatient Program (IOP; 3 weeks) to PE's compressed (2 week) format. Both interventions will be compared to a standard course of PE (12 weeks). In addition to PTSD symptomatology, outcome measurement includes other aspects of psychopathology as well as changes in social, occupational, and familial impairment. Potential negative outcomes of massed treatment, such as increased suicidal ideation or increased alcohol use, will be assessed, as will genetic predictors of PTSD subtype and treatment outcome. This study will inform the delivery of care for military-related PTSD and particularly the use of intensive or compressed treatments for active duty personnel.
Collapse
Affiliation(s)
| | | | | | | | - Peter W Tuerk
- Department of Human Services, University of Virginia, USA
| | | | | | | | - Marti Jett
- US Army Center for Environmental Health Research, Fort Detrick, MD, USA
| |
Collapse
|
37
|
Bakker LP, Eriksen S, Reichelt JG, Grov EK. The experiences of dealing with consequences of an avalanche - surviving soldiers' perspectives. Int J Qual Stud Health Well-being 2019; 14:1689066. [PMID: 31713468 PMCID: PMC6853213 DOI: 10.1080/17482631.2019.1689066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2019] [Indexed: 12/01/2022] Open
Abstract
Purpose: The aim of the study was to explore and describe experiences of daily life after having experienced an avalanche three decades ago.Method: This paper presents a qualitative study of 12 male survivors of an avalanche during their military service, interviewed 30 years post-disaster.Findings: A comprehensive understanding of the categories led to the latent theme "Finding my own way of managing and dealing with life". Findings revealed three categories describing experiences of daily living: (i) A comfortable life; (ii) A challenging, yet accomplished life; (iii) A demanding life. The first category represents a greater degree of using adaptive coping strategies for managing everyday life compared to the other two categories. The third category represents the group having the most challenging consequences. Among the three, the latter category conveys the most maladaptive coping strategies.Conclusions:The participants had different experiences with regards to their health and how they coped with their everyday life after the avalanche disaster. Insights into coping strategies may provide a guide for appropriate interventions for survivors dealing with traumatic events.
Collapse
Affiliation(s)
- Lars-Petter Bakker
- Norwegian Armed Forces Joint Medical Services, Institute of Military Psychiatry, Oslo, Norway
| | - Siren Eriksen
- Faculty of Health Studies, Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway, and VID Specialized university, Oslo, Norway
| | - Jon Gerhard Reichelt
- Norwegian Armed Forces Joint Medical Services, Institute of Military Psychiatry, Oslo, Norway
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
38
|
Barr N, Kintzle S. Can Mindfulness Help to Predict Veterans' Mental Health Service Utilization? SOCIAL WORK 2019; 64:329-338. [PMID: 31560776 DOI: 10.1093/sw/swz026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 03/20/2019] [Accepted: 05/20/2019] [Indexed: 06/10/2023]
Abstract
Post-9/11 era military veterans are at high risk for posttraumatic stress disorder (PTSD) and depression, but less than half of veterans who screen positive for these disorders seek mental health treatment. Self-stigma of mental illness has emerged as a core barrier to mental health service use (MHSU) in this population. Mindfulness is associated with attention control, nonjudgment, and reduced self-stigma in civilians, but associations between PTSD and depression, mindfulness, self-stigma, and MHSU have never been investigated in military veterans. The present study used a logistic regression modeling strategy to investigate main and interaction effects for PTSD, depression, mindfulness, and self-stigma on MHSU. Study findings demonstrated a positive main effect for PTSD and negative main effects for mindfulness and self-stigma on MHSU, and a positive interaction effect for mindfulness and PTSD on MHSU. Findings suggest that more mindful individuals with PTSD symptoms are more likely to seek mental health services, whereas less mindful individuals with PTSD symptoms are less likely to seek treatment. More research into the potential for mindfulness to enhance MHSU outcomes for military veterans appears warranted.
Collapse
|
39
|
A Latent Content Analysis of Barriers and Supports to Healthcare: Perspectives From Caregivers of Service Members and Veterans With Military-Related Traumatic Brain Injury. J Head Trauma Rehabil 2019; 33:342-353. [PMID: 29385014 DOI: 10.1097/htr.0000000000000373] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To identify barriers and supports that caregivers of individuals with military-related traumatic brain injury (TBI) encounter when navigating the military healthcare system; this information will be used as the foundation of a new patient-reported outcome measure. SETTING Community. PARTICIPANTS Forty-five caregivers of service members and veterans (SMV) who sustained a medically documented mild, moderate, severe, or penetrating TBI. DESIGN Latent content analysis. MAIN MEASURES Nine focus group discussions of barriers and supports to navigating the military healthcare system and community resources. RESULTS Latent content analysis indicated that caregivers discussed barriers (66%) and supports (34%) to obtaining care within the military healthcare system and the community. Caregivers most frequently discussed SMVs' interactions with healthcare, their own interactions with healthcare, family care, and community organizations. CONCLUSIONS Caregivers confront numerous challenges while pursuing healthcare services. Although much of the discussion focused on barriers and perceived unmet needs within the military healthcare system, caregivers also recognized supports within the military healthcare system and general community. Increased attention to accessibility and quality of services, as well as reducing financial burden, can lead to improved health-related quality of life for caregivers and their SMVs.
Collapse
|
40
|
Berkel LA, Nilsson JE, Kelly PJ, Anderson WM, Joiner AV, Davids C, Serpe CR. Faith of Our Sister Soldiers: National Guard Women Share Stories of Their Faith During and After Deployment. JOURNAL OF RELIGION AND HEALTH 2019; 58:1753-1769. [PMID: 31140092 DOI: 10.1007/s10943-019-00839-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In this qualitative study, we explored the religious and spiritual beliefs of women in the National Guard, the role of religion in their lives, and the effect of deployment and reintegration on women's belief systems. We conducted semi-structured interviews with 39 women service members who had been deployed. Results of the content analysis revealed five themes: (1) Religious Identity/Belief in God, (2) Religion/Spirituality has a Positive Impact, (3) Religious Activities, (4) Religiosity and Deployment, and (5) Religiosity/Spiritual Experiences Change over Time. Implications for future research and the incorporation of faith-based practices with women service members who may seek mental health treatment are discussed.
Collapse
Affiliation(s)
- LaVerne A Berkel
- Counseling and Educational Psychology, University of Missouri - Kansas City, 615 East 52nd Street, Kansas City, MO, 64110, USA.
| | - Johanna E Nilsson
- Counseling and Educational Psychology, University of Missouri - Kansas City, 615 East 52nd Street, Kansas City, MO, 64110, USA
| | - Patricia J Kelly
- Nursing Department, University of Missouri - Kansas City, Kansas City, USA
| | - William Matthew Anderson
- Counseling and Educational Psychology, University of Missouri - Kansas City, 615 East 52nd Street, Kansas City, MO, 64110, USA
| | - Alyssa V Joiner
- Counseling and Educational Psychology, University of Missouri - Kansas City, 615 East 52nd Street, Kansas City, MO, 64110, USA
| | - Christopher Davids
- Counseling and Educational Psychology, University of Missouri - Kansas City, 615 East 52nd Street, Kansas City, MO, 64110, USA
- Psychology Department, Westminster College, Salt Lake City, Utah, USA
| | - Christine R Serpe
- Counseling and Educational Psychology, University of Missouri - Kansas City, 615 East 52nd Street, Kansas City, MO, 64110, USA
| |
Collapse
|
41
|
Haselden M, Brister T, Robinson S, Covell N, Pauselli L, Dixon L. Effectiveness of the NAMI Homefront Program for Military and Veteran Families: In-Person and Online Benefits. Psychiatr Serv 2019; 70:935-939. [PMID: 31272337 DOI: 10.1176/appi.ps.201800573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of Homefront, a six-session, peer-taught family education program by the National Alliance on Mental Illness (NAMI), delivered in person or online, for families or support persons of military service members or of veterans with mental illness. METHODS Program participants completed online surveys at baseline, at the end of the program (postprogram), and at 3-month follow-up, which measured subjective empowerment, burden, coping, psychological distress, family functioning, experience of caregiving, and knowledge of mental illness. A mixed-effects model examined change over time. RESULTS A total of 119 individuals (in person, N=63 [53%]; online, N=56 [47%]) enrolled. Participants showed statistically significant improvement on all dimensions between baseline, postprogram, and follow-up, except for subjective burden, which improved between baseline and follow-up. Results for in-person and online formats did not differ. CONCLUSIONS The six-session NAMI Homefront program was associated with benefits for military and veteran family members and support persons.
Collapse
Affiliation(s)
- Morgan Haselden
- New York State Psychiatric Institute, New York (Haselden, Covell, Pauselli); National Alliance on Mental Illness, Arlington, Virginia (Brister, Robinson); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University (Covell, Pauselli, Dixon). Editor Emeritus Howard H. Goldman, M.D., Ph.D., served as decision editor on the manuscript
| | - Teri Brister
- New York State Psychiatric Institute, New York (Haselden, Covell, Pauselli); National Alliance on Mental Illness, Arlington, Virginia (Brister, Robinson); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University (Covell, Pauselli, Dixon). Editor Emeritus Howard H. Goldman, M.D., Ph.D., served as decision editor on the manuscript
| | - Suzanne Robinson
- New York State Psychiatric Institute, New York (Haselden, Covell, Pauselli); National Alliance on Mental Illness, Arlington, Virginia (Brister, Robinson); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University (Covell, Pauselli, Dixon). Editor Emeritus Howard H. Goldman, M.D., Ph.D., served as decision editor on the manuscript
| | - Nancy Covell
- New York State Psychiatric Institute, New York (Haselden, Covell, Pauselli); National Alliance on Mental Illness, Arlington, Virginia (Brister, Robinson); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University (Covell, Pauselli, Dixon). Editor Emeritus Howard H. Goldman, M.D., Ph.D., served as decision editor on the manuscript
| | - Luca Pauselli
- New York State Psychiatric Institute, New York (Haselden, Covell, Pauselli); National Alliance on Mental Illness, Arlington, Virginia (Brister, Robinson); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University (Covell, Pauselli, Dixon). Editor Emeritus Howard H. Goldman, M.D., Ph.D., served as decision editor on the manuscript
| | - Lisa Dixon
- New York State Psychiatric Institute, New York (Haselden, Covell, Pauselli); National Alliance on Mental Illness, Arlington, Virginia (Brister, Robinson); Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University (Covell, Pauselli, Dixon). Editor Emeritus Howard H. Goldman, M.D., Ph.D., served as decision editor on the manuscript
| |
Collapse
|
42
|
Predictors of attendance and dropout in three randomized controlled trials of PTSD treatment for active duty service members. Behav Res Ther 2019; 118:7-17. [DOI: 10.1016/j.brat.2019.03.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 02/12/2019] [Accepted: 03/04/2019] [Indexed: 11/18/2022]
|
43
|
Comtois KA, Kerbrat AH, DeCou CR, Atkins DC, Majeres JJ, Baker JC, Ries RK. Effect of Augmenting Standard Care for Military Personnel With Brief Caring Text Messages for Suicide Prevention: A Randomized Clinical Trial. JAMA Psychiatry 2019; 76:474-483. [PMID: 30758491 PMCID: PMC6495345 DOI: 10.1001/jamapsychiatry.2018.4530] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Accessible and cost-effective interventions for suicidality are needed to address high rates of suicidal behavior among military service members. Caring Contacts are brief periodic messages that express unconditional care and concern and have been previously shown to prevent suicide deaths, attempts, ideation, and hospitalizations. OBJECTIVE To test the effectiveness of augmenting standard military health care with Caring Contacts delivered via text message to reduce suicidal thoughts and behaviors over 12 months. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial was conducted at 3 military installations in the southern and western United States. Soldiers and Marines identified as being at risk of suicide were recruited between April 2013 and September 2016. The final follow-up was in September 2017. INTERVENTIONS Both groups received standard care, and the Caring Contacts group also received consisted of 11 text messages delivered on day 1, at week 1, at months 1, 2, 3, 4, 6, 8, 10, and 12, and on participants' birthdays. MAIN OUTCOMES AND MEASURES Primary outcomes were current suicidal ideation and suicide risk incidents (hospitalization or medical evacuation). Secondary outcomes were worst-point suicidal ideation, emergency department visits, and suicide attempts. Suicidal ideation was measured by the Scale for Suicide Ideation, suicide risk incidents, and emergency department visits by the Treatment History Interview; attempted suicide was measured by the Suicide Attempt Self-Injury Count. RESULTS Among 658 randomized participants (329 randomizely assigned to each group), data were analyzed for 657 individuals (mean [SD] age, 25.2 [6.1] years; 539 men [82.0%]). All participants reported suicidal ideation at baseline, and 291 (44.3%) had previously attempted suicide. Of the 657 participants, 461 (70.2%) were assessed at 12 months. Primary outcomes were nonsignificant. There was no significant effect on likelihood or severity of current suicidal ideation or likelihood of a suicide risk incident; there was also no effect on emergency department visits. However, participants who received Caring Contacts (172 of 216 participants [79.6%]) had lower odds than those receiving standard care alone (179 of 204 participants [87.7%]) of experiencing any suicidal ideation between baseline and follow-up (odds ratio, 0.56 [95% CI, 0.33-0.95]; P = .03) and fewer had attempted suicide since baseline (21 of 233 [9.0%] in the group receiving Caring Contacts vs 34 of 228 [14.9%] in the standard-care group; odds ratio, 0.52 [95% CI, 0.29-0.92]; P = .03). CONCLUSIONS AND RELEVANCE This trial provides inconsistent results on the effectiveness of caring text messages between primary and secondary outcomes, but this inexpensive and scalable intervention offers promise for preventing suicide attempts and ideation in military personnel. Additional research is needed. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01829620.
Collapse
Affiliation(s)
- Katherine Anne Comtois
- Department of Psychiatry & Behavioral Sciences, School of Medicine, University of Washington, Seattle
| | - Amanda H. Kerbrat
- Department of Psychiatry & Behavioral Sciences, School of Medicine, University of Washington, Seattle
| | - Christopher R. DeCou
- Department of Psychiatry & Behavioral Sciences, School of Medicine, University of Washington, Seattle
| | - David C. Atkins
- Department of Psychiatry & Behavioral Sciences, School of Medicine, University of Washington, Seattle
| | | | - Justin C. Baker
- Naval Medical Center Camp Lejeune, Camp Lejeune, North Carolina
| | - Richard K. Ries
- Department of Psychiatry & Behavioral Sciences, School of Medicine, University of Washington, Seattle
| |
Collapse
|
44
|
Haro E, Mader M, Noël PH, Garcia H, Vogt D, Bernardy N, Bollinger M, Pugh MJV, Finley EP. The Impact of Trust, Satisfaction, and Perceived Quality on Preference for Setting of Future Care Among Veterans With PTSD. Mil Med 2019; 184:e708-e714. [DOI: 10.1093/milmed/usz078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/27/2019] [Accepted: 03/19/2019] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Among US veterans, posttraumatic stress disorder (PTSD) is a high-prevalence condition; more than a million veterans of all combat eras are service-connected for this condition. Research on factors driving veterans’ decision-making regarding preferred setting for PTSD care has been limited. The purpose of this study was to understand factors associated with preferences for setting of future PTSD care among veterans service-connected for PTSD.
Materials and Methods
We conducted a cross-sectional mailed survey among veterans with service connection for PTSD in Texas and Vermont identified from the Veterans Services Network Corporate Mini Master File (VETSNET). Survey items were intended to elucidate PTSD healthcare decision-making and queried utilization, perceived need for care, and satisfaction and preferences for VA, community, and/or military setting for receipt of future PTSD care. Logistic regression was used to identify factors associated with preference for care setting. UT Health San Antonio’s Institutional Review Board determined this quality improvement project to be non-research.
Results
Veterans (n = 2,327) were surveyed with an overall response rate of 37.1%. Most veterans (72.4%) identified VA as a preferred site for their future PTSD care; a substantial, but smaller, number of veterans identified being interested in receiving care in community (39.9%) and military (12.7%) settings. Factors associated with preferences for future care setting included demographics (e.g., ethnicity, income), availability of healthcare coverage, prior experiences of care, and attitudes related to perceived quality of care and trust in VA.
Conclusions
These findings suggest that it is important to retain foundational mental health services within VA, as well as to continue to invest in building provider and network capacity in community settings, to ensure alignment with veteran preferences for care setting.
Collapse
Affiliation(s)
- Elizabeth Haro
- UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229
- South Texas Veterans Health Care System, 7400 Merton Minter Blvd (11C6), San Antonio, TX 78229-4404
| | - Michael Mader
- UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229
- South Texas Veterans Health Care System, 7400 Merton Minter Blvd (11C6), San Antonio, TX 78229-4404
| | - Polly H Noël
- UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229
- South Texas Veterans Health Care System, 7400 Merton Minter Blvd (11C6), San Antonio, TX 78229-4404
| | - Hector Garcia
- UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229
- Valley Coastal Bend Veterans Health Care System, 2601 Veterans Drive, Harlingen, TX 78550
| | - Dawne Vogt
- National Center for PTSD, Veterans Affairs Boston Healthcare System, 150 S Huntington Ave, Boston, MA 02130
- Department of Psychiatry, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118
| | - Nancy Bernardy
- National Center for PTSD, White River Junction VA Medical Center, 163 Veterans Dr, White River Junction, VT 05009
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, 1 Rope Ferry Rd, Hanover, NH 03755
| | - Mary Bollinger
- Central Arkansas Veterans Healthcare System, 4300 W 7th St, Little Rock, AR 72205
| | - Mary Jo V Pugh
- VA Salt Lake City Health Care System, 500 Foothill Dr, Salt Lake City, UT 84148
- University of Utah Health Science Center, 50 North Medical Dr, Salt Lake City, UT 84132
| | - Erin P Finley
- UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229
- South Texas Veterans Health Care System, 7400 Merton Minter Blvd (11C6), San Antonio, TX 78229-4404
| |
Collapse
|
45
|
Cole WR, Brockway JA, Fann JR, Ahrens AP, Hurst S, Hart T, Vuletic S, Bush N, Bell KR. Expressions of emotional distress in active duty military personnel with mild traumatic brain injury: A qualitative content analysis. MILITARY PSYCHOLOGY 2019. [DOI: 10.1080/08995605.2018.1503022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Wesley R. Cole
- Defense and Veterans Brain Injury Center, GDHS, Intrepid Spirit, Fort Bragg, North Carolina
| | - Jo Ann Brockway
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - Jesse R. Fann
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
| | - Angelica P. Ahrens
- Defense and Veterans Brain Injury Center, GDHS, Intrepid Spirit, Fort Bragg, North Carolina
| | - Samantha Hurst
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California
| | - Tessa Hart
- Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania
| | - Simona Vuletic
- National Center for Telehealth and Technology (T2), Joint Base Lewis-McChord, Washington
| | - Nigel Bush
- National Center for Telehealth and Technology (T2), Joint Base Lewis-McChord, Washington
- Psychological Health Center of Excellence, Defense Health Agency, Joint Base Lewis-McChord, Washington
| | - Kathleen R. Bell
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern, Dallas, Texas
| |
Collapse
|
46
|
Schuman DL, Lawrence KA, Pope N. Broadcasting War Trauma: An Exploratory Netnography of Veterans' YouTube Vlogs. QUALITATIVE HEALTH RESEARCH 2019; 29:357-370. [PMID: 30196750 DOI: 10.1177/1049732318797623] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This exploratory netnographic study is among the first to investigate military video blogs (milvlogs) posted by Iraq and Afghanistan veterans who self-published stories on military-related trauma to YouTube. Studies have shown that self-published milvlogs provide benefits such as education, social support, and self-management of chronic physical and psychological illness. The aim of this study was to explore combat veterans' milvlogs and to determine themes that emerged across the videos. We transcribed and analyzed content from 17 milvlogs. Our analysis yielded seven themes: motivation, loss, managing symptoms, help-seeking, guilt and shame, suicide, and connecting to other veterans. We concluded that veterans were initially drawn to vlogging to connect to others. Vlogging also served as a medium for combat veterans to tell their stories, position these stories against others' experiences, and engage in outreach and advocacy. Finally, milvlogs may provide an easily accessible resource for developing preventive and/or mental health treatment/support links.
Collapse
Affiliation(s)
- Donna L Schuman
- 1 University of Kentucky College of Social Work, Lexington, Kentucky, USA
| | - Karen A Lawrence
- 1 University of Kentucky College of Social Work, Lexington, Kentucky, USA
| | - Natalie Pope
- 1 University of Kentucky College of Social Work, Lexington, Kentucky, USA
| |
Collapse
|
47
|
Knobloch LK, Knobloch-Fedders LM, Yorgason JB. Mental health symptoms and the reintegration difficulty of military couples following deployment: A longitudinal application of the relational turbulence model. J Clin Psychol 2018; 75:742-765. [PMID: 30569467 DOI: 10.1002/jclp.22734] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 10/01/2018] [Accepted: 11/06/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Understanding the factors that predict the reintegration difficulty of military couples during the postdeployment transition has important implications for theory, research, and practice. Building on the logic of the relational turbulence model, this paper evaluates the relationship processes of reunion uncertainty and reintegration interference from a partner as mediators of the connection between people's mental health symptoms and their difficulty with reintegration after deployment. METHOD Dyadic longitudinal data were collected from 555 US military couples once per month for 8 consecutive months. RESULTS Findings mapped the trajectory of reintegration difficulty and suggested reunion uncertainty and reintegration interference from a partner as mediators of the link between people's depressive and posttraumatic stress symptoms and the magnitude of their reintegration difficulty. CONCLUSION These results highlight relationship processes as a key domain of intervention to preserve the well-being of military couples during the postdeployment transition.
Collapse
Affiliation(s)
- Leanne K Knobloch
- Department of Communication, University of Illinois, Urbana, Illinois
| | - Lynne M Knobloch-Fedders
- Department of Counselor Education and Counseling Psychology, Marquette University, Milwaukee, Wisconsin
| | | |
Collapse
|
48
|
Military sexual trauma and suicidal behavior among National Guard personnel. Compr Psychiatry 2018; 87:1-6. [PMID: 30172073 DOI: 10.1016/j.comppsych.2018.08.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/13/2018] [Accepted: 08/17/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Preliminary evidence suggests military sexual trauma (MST) may be associated with increased risk for suicidal behaviors among active duty military personnel and veterans. Among National Guard personnel, a high-risk subgroup, MST and suicide risk have not received much empirical attention. PURPOSE To examine the association of MST with suicide ideation and suicide attempts among National Guard personnel. PROCEDURES N = 997 National Guard personnel from Idaho and Utah participated in an anonymous online survey. Weighted analyses were conducted to minimize sampling bias. MAIN FINDINGS 9% of participants had a history of MST (6% of men, 28% of women). Among participants reporting MST, 68% reported a service member perpetrator and 44% reported a civilian perpetrator (12% reported both). A history of MST was associated with significantly increased risk for lifetime suicide attempt. MST remained a significant predictor of lifetime suicide attempt even when restricting the sample to the subgroup with a history of suicidal thoughts (n = 257, 27% of full sample). When adjusting for premilitary sexual victimization, MST was no longer significantly associated with lifetime suicide attempts, but premilitary sexual victimization was. CONCLUSIONS The rate of MST among National Guard personnel is comparable to rates among active duty military personnel, although the perpetrators of MST are less likely to be service members. MST is a risk factor for suicide attempts, but premilitary sexual victimization is a relatively stronger risk factor.
Collapse
|
49
|
Turner RA, Szaboova L, Williams G. Constraints to healthcare access among commercial fishers. Soc Sci Med 2018; 216:10-19. [DOI: 10.1016/j.socscimed.2018.09.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 08/07/2018] [Accepted: 09/14/2018] [Indexed: 01/08/2023]
|
50
|
Nam B, Wilcox HC, Hilimire M, DeVylder JE. Perceived need for care and mental health service utilization among college students with suicidal ideation. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2018; 66:713-719. [PMID: 29384469 DOI: 10.1080/07448481.2018.1434779] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 12/09/2017] [Accepted: 01/28/2018] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This study aimed to identify correlates of service utilization and perceived need for care among college students with suicidal ideation. PARTICIPANTS Respondents were recruited from introductory psychology courses at an undergraduate college during the Fall 2014 semester. METHODS Independent correlates of (1) mental health service utilization, (2) self-perceived need, and (3) other-perceived need for mental health services among college students (N = 190) with suicidal ideation were identified. RESULTS Service utilization was associated with need for care as perceived by others. Perceived need for care by others was associated with suicidal ideation intensity and suicide attempt history. Perceived need by the respondents themselves was correlated with depression severity, sex, and race but was not independently associated with actual service utilization. CONCLUSIONS Perceived need by others was the sole significant correlate of service utilization, suggesting it is an important target for public health interventions aimed at facilitating pathways into mental health treatment.
Collapse
Affiliation(s)
- Boyoung Nam
- a School of Social Work, University of Maryland , Baltimore , Maryland , USA
| | - Holly C Wilcox
- b Department of Mental Health , Johns Hopkins Schools of Medicine and Bloomberg School of Public Health, Johns Hopkins University , Baltimore , Maryland , USA
| | - Matthew Hilimire
- c Department of Psychology , The College of William & Mary , Williamsburg , Virginia , USA
| | - Jordan E DeVylder
- a School of Social Work, University of Maryland , Baltimore , Maryland , USA
- d Graduate School of Social Service , Fordham University , New York , New York , USA
| |
Collapse
|