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Unique barriers to seeking mental health care while deployed: OEF/oif servicewomen's perceptions and provider effects


Wednesday, November 6, 2013

Michelle Mengeling, Ph.D., CADRE Research (151), Iowa City VA Health Care System, Iowa City, IA
Brenda M. Booth, PhD, Division of Health Services Research, University of Arkansas for Medical Sciences, Little Rock, AR
James Torner, Ph.D., College of Public Health, University of Iowa, Iowa City, IA
Anne Sadler, Ph.D., CADRE Research (151), Iowa City VAHealth Care Center, University of Iowa Department of Psychiatry, Iowa City, IA
Deployed servicewomen report unique barriers and facilitators to mental health (MH) care. 665 Reserve/National Guard and 674 Active Component Operation Enduring Freedom or Operation Iraqi Freedom (OEF/OIF) era Midwestern servicewomen were stratified by deployment (never deployed, deployed to Iraq and/or Afghanistan (I/A), deployed elsewhere) and included 1.) Active Duty (79%)/ Veteran (21%); and 2.) Officers (29%)/ Enlisted (71%) personnel. Deployed participants were more likely to know where to receive MH counseling (93% v 85%, p<.001); believe MH prescriptions could interfere with their job performance (48% v 40%, 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. Among those deployed, concerns about MH care confidentiality during deployment were common (50%). Half said they would informally talk with off-duty healthcare providers if they had a MH concern during deployment. Those who believed 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). Deployed servicewomen endorsed methods of seeking care that may put deployed healthcare providers at high risk for burnout or secondary traumatization by endorsing indirect strategies to access health care providers for MH concerns. Deployed health care providers must be prepared to address both physical and mental health concerns of deployed servicewomen. Deployed healthcare providers may be a high risk population for burnout or secondary traumatization.

Learning Areas:

Occupational health and safety

Learning Objectives:
Evaluate whether deployment status is associated with greater self-reported barriers to mental health (MH) care between deployed and non-deployed U.S. servicewomen. Discuss deployed servicewomen’s strategies to insure MH confidentiality by presenting with physical health concerns to providers. Describe possible effects to both servicewomen and health care providers caused by MH confidentiality concerns during deployment.

Keyword(s): Mental Health Care, Occupational Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a primary investigator and co-investigator on multiple grants focusing on the health and safety of women in the military. Among my scientific interests have been access to care, post-deployment mental health especially in rural veteran populations, and military sexual assault.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.