Abstract
Objective: Veterans from the wars in Afghanistan and Iraq (OEF/OIF) report high rates of mental distress especially affective disorders. Ensuring continuity of care across institutions is a priority for both the Department of Defense (DoD) and the Veterans Health Administration (VHA), yet this process is not monitored nor are medical records integrated. This study assessed transition from DoD to VHA and subsequent psychiatric care of service members traumatically injured in OEF/OIF. Methods: Inpatients at a DoD trauma treatment facility discharged in FY02-FY06 (n = 994) were tracked into the VHA via archival data (n = 216 OEF/OIF veterans). Mental health utilization in both systems was analyzed. Results: VHA users were 9% female, 15% Hispanic; mean age 32 (SD = 10; range 19-59). No DoD inpatients received diagnoses of post-traumatic stress disorder (PTSD); 21% had other mental health diagnoses, primarily drug abuse. In the VHA, 38% sought care within 6 months of DoD discharge; 75% within 1 year. VHA utilization increased over time, with 88-89% of the transition cohort seeking care in FY07-FY09. Most accessed VHA mental health services (81%) and had VHA psychiatric diagnoses (71%); half met criteria for depression (27%) or PTSD (38%). Treatment retention through FY09 was significantly greater for those receiving psychiatric care: 98% vs 62% of those not receiving psychiatric care (x2 = 53.3; p < .001). Limitations: DoD outpatient data were not available. The study relied on administrative data. Conclusions: Although physical trauma led to hospitalization in the DoD, high rates of psychiatric disorders were identified in subsequent VHA care, suggesting delay in development or recognition of psychiatric problems.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 226-230 |
| Number of pages | 5 |
| Journal | Journal of Affective Disorders |
| Volume | 130 |
| Issue number | 1-2 |
| DOIs | |
| State | Published - Apr 2011 |
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Keywords
- Combat disorders
- Health services
- Iraq War 2003-
- Mental health services
- Veterans
ASJC Scopus subject areas
- Psychiatry and Mental health
- Clinical Psychology
Cite this
Transition from military to VHA care : Psychiatric health services for Iraq/Afghanistan combat-wounded. / Copeland, Laurel A.; Zeber, John E.; Bingham, Mona O.; Pugh, Mary Jo; Noel, Polly H; Schmacker, Eric R.; Lawrence, Valerie A.
In: Journal of Affective Disorders, Vol. 130, No. 1-2, 04.2011, p. 226-230.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Transition from military to VHA care
T2 - Psychiatric health services for Iraq/Afghanistan combat-wounded
AU - Copeland, Laurel A.
AU - Zeber, John E.
AU - Bingham, Mona O.
AU - Pugh, Mary Jo
AU - Noel, Polly H
AU - Schmacker, Eric R.
AU - Lawrence, Valerie A.
PY - 2011/4
Y1 - 2011/4
N2 - Objective: Veterans from the wars in Afghanistan and Iraq (OEF/OIF) report high rates of mental distress especially affective disorders. Ensuring continuity of care across institutions is a priority for both the Department of Defense (DoD) and the Veterans Health Administration (VHA), yet this process is not monitored nor are medical records integrated. This study assessed transition from DoD to VHA and subsequent psychiatric care of service members traumatically injured in OEF/OIF. Methods: Inpatients at a DoD trauma treatment facility discharged in FY02-FY06 (n = 994) were tracked into the VHA via archival data (n = 216 OEF/OIF veterans). Mental health utilization in both systems was analyzed. Results: VHA users were 9% female, 15% Hispanic; mean age 32 (SD = 10; range 19-59). No DoD inpatients received diagnoses of post-traumatic stress disorder (PTSD); 21% had other mental health diagnoses, primarily drug abuse. In the VHA, 38% sought care within 6 months of DoD discharge; 75% within 1 year. VHA utilization increased over time, with 88-89% of the transition cohort seeking care in FY07-FY09. Most accessed VHA mental health services (81%) and had VHA psychiatric diagnoses (71%); half met criteria for depression (27%) or PTSD (38%). Treatment retention through FY09 was significantly greater for those receiving psychiatric care: 98% vs 62% of those not receiving psychiatric care (x2 = 53.3; p < .001). Limitations: DoD outpatient data were not available. The study relied on administrative data. Conclusions: Although physical trauma led to hospitalization in the DoD, high rates of psychiatric disorders were identified in subsequent VHA care, suggesting delay in development or recognition of psychiatric problems.
AB - Objective: Veterans from the wars in Afghanistan and Iraq (OEF/OIF) report high rates of mental distress especially affective disorders. Ensuring continuity of care across institutions is a priority for both the Department of Defense (DoD) and the Veterans Health Administration (VHA), yet this process is not monitored nor are medical records integrated. This study assessed transition from DoD to VHA and subsequent psychiatric care of service members traumatically injured in OEF/OIF. Methods: Inpatients at a DoD trauma treatment facility discharged in FY02-FY06 (n = 994) were tracked into the VHA via archival data (n = 216 OEF/OIF veterans). Mental health utilization in both systems was analyzed. Results: VHA users were 9% female, 15% Hispanic; mean age 32 (SD = 10; range 19-59). No DoD inpatients received diagnoses of post-traumatic stress disorder (PTSD); 21% had other mental health diagnoses, primarily drug abuse. In the VHA, 38% sought care within 6 months of DoD discharge; 75% within 1 year. VHA utilization increased over time, with 88-89% of the transition cohort seeking care in FY07-FY09. Most accessed VHA mental health services (81%) and had VHA psychiatric diagnoses (71%); half met criteria for depression (27%) or PTSD (38%). Treatment retention through FY09 was significantly greater for those receiving psychiatric care: 98% vs 62% of those not receiving psychiatric care (x2 = 53.3; p < .001). Limitations: DoD outpatient data were not available. The study relied on administrative data. Conclusions: Although physical trauma led to hospitalization in the DoD, high rates of psychiatric disorders were identified in subsequent VHA care, suggesting delay in development or recognition of psychiatric problems.
KW - Combat disorders
KW - Health services
KW - Iraq War 2003-
KW - Mental health services
KW - Veterans
UR - http://www.scopus.com/inward/record.url?scp=79953222176&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79953222176&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2010.10.017
DO - 10.1016/j.jad.2010.10.017
M3 - Article
VL - 130
SP - 226
EP - 230
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
IS - 1-2
ER -