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McLean CL, Turchik JA, Kimerling R. Mental Health Beliefs, Access, and Engagement with Military Sexual Trauma-Related Mental Health Care. Journal of general internal medicine. 2022 Sep 1; 37(Suppl 3):742-750.
BACKGROUND: Military sexual trauma (MST) is associated with negative mental health outcomes. Mental health beliefs, such as stigma or secondary victimization, have been identified as possible barriers to care; however, it is unclear whether such beliefs impact receiving care. OBJECTIVE: To assess if mental health beliefs impact MST-related mental health care access and engagement. DESIGN: Veterans completed a survey following detection of MST. Survey data were linked to Veteran''s Health Administration administrative data in order to examine associations with outpatient MST-related care in the year following MST detection. PARTICIPANTS: A national sample of women and men Veterans (N = 1,185) with newly detected MST who reported a perceived need for MST-related mental health treatment. MAIN MEASURES: Building on prior work that identified four latent classes of mental health beliefs (Hahn et al., J Trauma Stress 34:394-404, 2020; low barrier, stigma-related beliefs, negative perceptions of care, high barrier), we examined associations with outpatient mental health care indicated by a provider as related to MST. Care was examined in total, as well as the specific categories of medication management, individual psychotherapy, and group psychotherapy. KEY RESULTS: Access to care following MST detection was high: most (71.6%) Veterans had an MST-related mental health visit within 30 days, and nearly all (83.6%) within 180 days, with the median number of days to receiving care being 2. Negative perceptions of care predicted a lower likelihood of treatment engagement (3+ encounters) with MST-related individual psychotherapy (OR = 0.65, 95% CI (0.43-0.96)), whereas the stigma-related beliefs and high barrier classes did not. CONCLUSIONS: There appears to be excellent access to mental health care among Veterans with a perceived need for MST-related mental health treatment. However, treatment beliefs that represented negative perceptions of care may serve as barriers to engagement. Interventions targeting negative perceptions of care during early encounters could help promote subsequent engagement.