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Mengeling M, Booth B, Torner J, Sadler AG. OEF/OIF Reserve and National Guard Women Veteran Barriers to Mental Healthcare: Deployment & Provider Effects. Paper presented at: VA HSR&D National Meeting; 2011 Feb 18; National Harbor, MD.
Objectives: Determine if deployment status is associated with greater self-reported barriers to mental health (MH) care. Methods: 665 women participated in a cross-sectional study of current health, health risk behaviors, and care utilization. OEF/OIF-era Reserve and National Guard (R/NG) women Veterans were sampled from five Midwestern states and stratified by deployment (never deployed, deployed to Iraq or Afghanistan, deployed elsewhere). Results: Deployed participants (n = 521) were more likely to believe MH prescriptions could interfere with their job performance (48%v35%; OR = 1.41 (1.00-1.99)); to know where to receive counseling while in the R/NG (87%v74%; OR = 2.33, 1.49-3.66); and to believe their unit wouldn't lose confidence in them if they sought MH care (49%v38%; OR 1.36, .96-1.92) relative to non-deployed peers. Those deployed to Iraq/Afghanistan were less-likely to believe that seeking MH care treatment would harm their career than those deployed elsewhere (32%v41%; OR = .61, .43-.86). Half of women deployed to Iraq/Afghanistan had concerns their MH care would not remain confidential while deployed. Almost half (47.1%) said they would informally talk with an off-duty healthcare provider if they had a physical or MH concern during deployment. Those who believed their care would not remain confidential were more likely to endorse presenting a physical complaint to see a provider in order to bring up MH concerns (50%v35%; p < .01). Implications: Deployed R/NG personnel reported knowing where to seek MH care and were less concerned about unit reaction than their non-deployed counterparts. However, they were less likely to seek care because of concerns about prescription effects on job performance. Those deployed to Iraq/Afghanistan reported that they would present with a physical health complaint in order to seek MH care. Seeking physical and mental healthcare from off-duty providers was another care seeking method of deployed personnel. Impacts: R/NG servicewomen who have been deployed (compared to those who haven't) report unique barriers and facilitators to MH care. VA primary care clinicians must be educated that deployed R/NG servicewomen may have concerns about confidentiality and if so are acculturated to access MH care by presentation with physical complaints. Deployed healthcare providers may be a high risk population for burnout or secondary traumatization.
