Mental Health
Prevalence and predictors of non-presentation for mental health services among referred U.S. military personnel Andrew J. MacGregor* Andrew MacGregor James M. Zouris Amber L. Dougherty Sarah M. Jurick
Introduction: Mental health (MH) disorders pose a significant burden to the wellness of military personnel, and seeking care is an essential first step in the treatment pathway. To date, little information exists on non-presentation for MH services in the U.S. military.
Methods: The study sample included 14,289 U.S. service members who responded to an annual screening and were referred for MH services. Medical records were examined to identify those who did not present for MH services within 90 days of referral. Independent variables included demographics (age, rank, service branch, gender), behaviors (alcohol use, physical activity, tobacco use), perceived health (overall health, pain), and prior presenting behavior (contact with MH and primary care). Multivariable logistic regression was used to assess the association between independent variables and non-presentation for MH services. Among a subgroup of individuals with probable posttraumatic stress disorder (PTSD) and depression, adjusted means for severity scores were examined by non-presentation status.
Results: Overall, 34.0% of service members did not present for MH services after referral. ORs and 95% CIs for the independent variables are reported in the figure. Non-presenters were more likely to be men, in the Marines, and have lower prior presentation to MH and primary care, better perceived health, and healthier behaviors. Non-presenters also had significantly lower severity scores for PTSD and depression.
Conclusion: This study identified a key subgroup of military personnel who were less likely to present for MH services, with the strongest predictor being prior presenting behavior. Subsequent studies are needed to compare functional outcomes of those presenting versus not presenting for MH services. Future research could also develop clinical decision tools to identify personnel at risk of not presenting for MH services to allow for interventions that encourage follow-up care.
