Improving Mental Health Treatment Utilization in Military Veterans: Examining the Effects of Perceived Need for Care and Social Support.

OBJECTIVE: Many veterans with mental health problems do not adequately utilize needed care. Research has focused on identifying barriers to mental health care in veterans. METHOD: The current study adds to existing literature by examining whether perceived need for treatment and social support affect treatment utilization in a national longitudinal survey of Iraq and Afghanistan veterans (n = 1090). RESULTS: The Health Beliefs Model (HBM) postulates that a key reason why patients fail to obtain needed care is their belief "it's up to me to handle my own problems." This view was endorsed by 42% in the current national sample of veterans and was found in multivariate analysis to predict less treatment seeking in the next year. Mediation analysis revealed that veterans with higher ratings of social support were less likely to believe they needed to solve mental health problems on their own, indirectly equating to higher odds of treatment use. Simultaneously, findings indicated that posttraumatic stress disorder (PTSD) had a direct effect on more mental health visits but was also associated with higher endorsement that one needed to handle one's own problems and thus had an indirect effect of reducing mental health visits. CONCLUSION: Both social support and PTSD affected veterans' perceptions of needing to solve one's own problems, significantly predicted follow-up with mental health care. As a result, the findings indicate that clinicians' should explore veterans' belief systems about perceived treatment need as well as investigate the role of social support to improve mental health treatment utilization.

Duke Scholars

Author Eric Bradley Elbogen Psychiatry & Behavioral Sciences, Behavioral Medicine & Neur ...