Military Sexual Trauma: Important Mental Health Issue for OEF/OIF Veterans
FINDINGS:
- Of the 125,729 OEF/OIF Veterans who received VA primary care or mental health services between 10/01 and 9/07, 15% of women and 0.7% of men reported military sexual trauma (MST) based on results of universal screening that asks about sexual assault or harassment.
- Women and men who reported a history of MST were significantly more likely than those who did not to be diagnosed with mental health conditions, including PTSD, other anxiety disorders, depression, and substance use disorders. This finding remained consistent after adjusting for demographics, healthcare use, and military service characteristics.
- The relationship of MST to PTSD was stronger among women compared to men, suggesting that MST may be a particularly relevant issue for women Veterans seeking care for PTSD.
- There were high rates of post-deployment mental health conditions among all OEF/OIF patients.
BACKGROUND:
Emerging research suggests that an estimated 19-42% of OEF/OIF Veterans suffer from mental health conditions. One of the contributors to this burden may be exposure to sexual assault or harassment during service, referred to as military sexual trauma (MST), yet there are currently no data investigating MST in the context of post-deployment mental health among OEF/OIF Veterans. This study is the first national, population-based assessment of the mental health profile associated with a history of MST among OEF/OIF Veterans using VA healthcare services. Utilizing data from VA’s electronic medical records, investigators describe the prevalence of MST among Veterans (17,580 women and 108,149 men) who received VA primary care or mental health services between 10/01 and 9/07 and were screened for MST. [VA implemented universal MST screening in 2002.] In addition, investigators assessed post-deployment mental health conditions among Veterans reporting a history of MST.
LIMITATIONS:
- The prevalence of MST applies only to Veterans seeking care at VHA and may not represent the rate among Veterans cared for in the private sector.
- The rate of MST and the rate of mental illness reported in this study likely represent conservative estimates for Veterans within VHA, given that both tend to be under-reported.
- These analyses were cross-sectional, so the exact timing of MST, deployment, and the onset of mental health conditions cannot be determined. Thus, no conclusion can be drawn about causal relationships between MST and mental health.
- The analysis did not separate the effects of different levels of MST (e.g. harassment vs. sexual assault).
IMPLICATIONS:
- These results are consistent with data suggesting that patients who experience MST frequently present with substantial mental health treatment needs. VA’s ability to detect MST in this recently returned cohort will help focus early interventions for this population.
AUTHOR/FUNDING INFORMATION:
This study was funded by HSR&D (IAE 05-291 and SDR 07-331). Dr. Kimerling is part of HSR&D’s Center for Health Care Evaluation and VA’s National Center for Post-traumatic Stress Disorder.
Kimerling R, Street A, Pavao J, et al. Military-Related Sexual Trauma among VHA Patients Returning from Afghanistan and Iraq. American Journal of Public Health June 17, 2010, e-pub ahead of print.
