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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).
Objective:
To identify preinjury variables related to mental health treatment utilization at 2 years post-traumatic brain injury (TBI).
Setting:
Veterans Affairs (VA) TBI Model Systems includes 5 VA Polytrauma Rehabilitation Centers.
Participants:
Veterans and service members enrolled in TBI Model Systems who completed the year 2 follow-up assessment and provided mental health information. Sample was largely male (97%) and White (72%), with median age of 30 years.
Design:
Participants with elevated mental health symptoms were identified by measures of depression, anxiety, and posttraumatic distress; suicide attempt in the past year; or problematic substance use in the past year. Forty-seven percent of participants had elevated mental health symptoms at 2 years postinjury. Among those with elevated symptoms, comparisons were made between those who sought mental health treatment in past year and those who did not.
Main Measures:
Demographic, historic, environmental, psychological/mental health, and injury/rehabilitation variables.
Results:
Within the sample, 23% denied utilizing mental health services. Nonutilizers were more likely to deny a preinjury mental health treatment history, to report problematic substance use at year 2, and to report lower levels of internalizing symptoms than the treatment utilizers.
Conclusion:
Veterans and service members with elevated mental health symptoms may require tailored tactics to promote treatment utilization post-TBI.
