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Mengeling M, Booth BM, Torner J, Sadler AG. OEF/OIF Servicewomen’s Perception of Seeking Mental Health Care While Deployed: Unique Barriers and Provider Effects. Poster session presented at: AcademyHealth Annual Research Meeting; 2013 Jun 24; Baltimore, MD.
Research Objective: To determine if deployment status is associated with greater self-reported barriers to mental health (MH) care. Study Design: Parallel cross-sectional studies of current health, health risk behaviors, and military experiences using a computer-assisted telephone interview (CATI) to collect data from U.S. servicewomen. Population Studied: 665 Reserve and National Guard (RNG) and 674 Active Component (AC) Operation Enduring Freedom or Operation Iraqi Freedom OEF/OIF-era servicewomen were sampled from five Midwestern states and stratified by deployment (never deployed, deployed to Iraq and/or Afghanistan (I/A), deployed elsewhere). The sample was made up of both 1.) Active Duty (79%) and Veteran (21%); and 2.) Officers (29%) and Enlisted (71%) personnel. Principal Findings: Deployed participants were more likely to know where to receive MH counseling (93% v 85%, p < .001); to believe MH prescriptions could interfere with their job performance (48%v40%, p < .01); that they would be seen as weak (38% v 29%, p < .001); but less likely to believe their unit would lose confidence in them (49% v 35%, p < .002) if they sought MH care. Half of those deployed to I/A had concerns their MH care would not remain confidential. Half said they would informally talk with off-duty healthcare providers if they had a 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 (53% v 39%; p < .001). Conclusions Deployed servicewomen report unique barriers and facilitators to MH care compared to their non-deployed counterparts. Among those deployed, concerns about confidentiality of seeking MH care during deployment were common. Perceived stigmas were commonly endorsed and may prevent servicewomen from seeking needed MH care. Deployment presents unique challenges to servicewomen obtaining confidential mental health care. Deployed servicewomen endorsed methods of seeking care that may put deployed healthcare providers at high risk for burnout or secondary traumatization. Servicewomen were likely to endorse indirect strategies to gain access to health care provider to address MH concerns. Deployed health care providers must be prepared to address both physical and mental health concerns of deployed servicewomen. Implications for Policy, Delivery or Practice: Clinicians must be educated that deployed 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.