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Rates and Associated Factors of Secondary Mental Health Care Utilisation among Ex-Military Personnel in the United States: A Narrative Review

1
King’s Centre for Military Health Research, King’s College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK
2
Combat Stress, Tyrwhitt House, Oaklawn Road, Leatherhead, Surrey KT22 0BX, UK
3
Department of Psychological Medicine, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London SE5 8AF, UK
4
Academic Department of Military Mental Health, King’s College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK
*
Author to whom correspondence should be addressed.
Joint last authors.
Healthcare 2019, 7(1), 18; https://doi.org/10.3390/healthcare7010018
Received: 18 December 2018 / Revised: 16 January 2019 / Accepted: 19 January 2019 / Published: 28 January 2019
(This article belongs to the Special Issue Military Mental Health)
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Abstract

Little is known about ex-serving military personnel who access secondary mental health care. This narrative review focuses on studies that quantitatively measure secondary mental health care utilisation in ex-serving personnel from the United States. The review aimed to identify rates of mental health care utilisation, as well as the factors associated with it. The electronic bibliographic databases OVID Medline, PsycInfo, PsycArticles, and Embase were searched for studies published between January 2001 and September 2018. Papers were retained if they included ex-serving personnel, where the majority of the sample had deployed to the recent conflicts in Iraq or Afghanistan. Fifteen studies were included. Modest rates of secondary mental health care utilisation were found in former military members—for mean percentage prevalence rates, values ranged from 12.5% for at least one psychiatric inpatient episode, to 63.2% for at least one outpatient mental health appointment. Individuals engaged in outpatient care visits most often, most likely because these appointments are the most commonly offered source of support. Post-traumatic stress disorder, particularly re-experiencing symptoms, and comorbid mental health problems were most consistently associated with higher mental health care utilisation. Easily accessible interventions aimed at facilitating higher rates of help seeking in ex-serving personnel are recommended. View Full-Text
Keywords: mental health care utilisation; mental health; secondary mental health care; post-traumatic stress disorder; veterans; narrative review; help-seeking mental health care utilisation; mental health; secondary mental health care; post-traumatic stress disorder; veterans; narrative review; help-seeking
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Mark, K.M.; Murphy, D.; Stevelink, S.A.; Fear, N.T. Rates and Associated Factors of Secondary Mental Health Care Utilisation among Ex-Military Personnel in the United States: A Narrative Review. Healthcare 2019, 7, 18.

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