Working toward peace by providing civilian health and mental health services to active duty military personnel- an update

Objective: The increasing health and mental health problems of military personnel have emerged as a major public health epidemic. We present findings from an ongoing effort to identify social variables that mediate health and mental health disorders among active duty GIs and veterans to assess whether civilian services offered a viable alternative to military services. Methods: Our sample was drawn from the clients of a nationwide network of civilian physicians and mental health service providers (the Civilian Medical Resources Network) who offered their services to active-duty and veteran military personnel. Using a multi-method approach, we conducted quantitative and qualitative analysis of data collected during intake and follow-up interviews. Results: Among clients, 36% identified themselves as belonging to a minority group and 20% were female. Depression (71%), PTSD (55%), other anxiety disorder (45%), and Alcohol Use Disorder (31%) were the most common diagnoses. No consistent relationship between race/ethnicity and mental disorders emerged. In multivariate analyses, male gender was significantly and positively associated with an other anxiety disorder diagnosis (p=0.028) while pre-military physical health conditions (p=0.015) and mistrust of the military (p=0.019) were significantly associated with the presence of suicidal ideation. Many clients reported suicidal ideation (88%). Qualitative analyses revealed that clients tended to mistrust the military command to address their health and mental health needs. In follow-up interviews, clients generally expressed satisfaction and gratitude for the civilian services. Conclusion: The continuing and largely favorable results provide a rationale for further assessment of military personnel characteristics who prefer civilian to military services.