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Postrehabilitation Mental Health Treatment Utilization in Veterans With Traumatic Brain Injury: A VA TBI Model
Jacob A Finn1, Greg J Lamberty, Xinyu Tang
1Extended Care & Rehabilitation Service, Minneapolis VA Health Care System, Minneapolis, Minnesota (Dr Finn); Defense and Veteran Brain Injury Center (DVBIC), Minneapolis, Minnesota (Drs Finn and Lamberty); Department of Psychiatry, University of Minnesota-Twin Cities, Minneapolis (Dr Finn); Mental Health Service, Minneapolis VA Health Care System, Minneapolis, Minnesota (Dr Lamberty); Biostatistics Program, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock (Dr Tang and Ms Saylors); Mental Health Service, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia (Dr Stevens); Department of Psychology, Virginia Commonwealth University, Richmond (Dr Stevens); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond (Dr Stevens); Defense and Veterans Brain Injury Center (DVBIC), Richmond, Virginia (Dr Stevens); and MHBS, James A. Haley Veterans' Hospital, Tampa, Florida (Dr Kretzmer).
Many veterans with elevated mental health symptoms after traumatic brain injury (TBI) do not seek treatment. Preinjury history and substance use influence mental health care utilization post-TBI.
Area of Science:
- Neuroscience
- Psychiatry
- Rehabilitation Medicine
Background:
- Traumatic brain injury (TBI) is a significant concern for military personnel and veterans.
- Mental health conditions are common sequelae of TBI, impacting long-term recovery and quality of life.
- Understanding factors influencing mental health treatment utilization is crucial for effective post-TBI care.
Purpose of the Study:
- To identify preinjury variables associated with mental health treatment utilization 2 years after TBI.
- To explore differences between individuals who utilized mental health services and those who did not, among those with elevated symptoms.
Main Methods:
- The study analyzed data from the Veterans Affairs (VA) TBI Model Systems, including veterans and service members with TBI.
- Participants completed a 2-year follow-up assessment, with mental health status assessed through measures of depression, anxiety, posttraumatic distress, suicide attempts, and substance use.
- Preinjury demographic, historic, environmental, psychological, and injury/rehabilitation variables were examined.
Main Results:
- Nearly half (47%) of participants exhibited elevated mental health symptoms at 2 years post-TBI.
- Twenty-three percent of participants with elevated symptoms did not utilize mental health services.
- Non-utilizers were more likely to have no preinjury mental health treatment history, report current problematic substance use, and have lower levels of internalizing symptoms.
Conclusions:
- A significant proportion of veterans and service members with elevated mental health symptoms post-TBI do not access needed care.
- Preinjury mental health history and current substance use patterns are associated with treatment utilization.
- Tailored interventions are necessary to promote mental health treatment seeking in this population.
