Mental Health Service Use in Depressed Military Personnel: A Systematic Review

Area of Science:

• Military mental health
• Public health
• Psychiatry

Background:

• Major depression significantly impacts military personnel's health and operational readiness.
• A substantial treatment gap exists, with many individuals not accessing available mental health services.
• Systematic review of the depression treatment gap in military populations is lacking.

Purpose of the Study:

• To systematically review the scientific literature on the major depression treatment gap in military organizations.
• To quantify mental health service use among active-duty military personnel in Five-Eye countries.

Main Methods:

• Systematic search of EMBASE, MEDLINE, and PsychINFO databases.
• Inclusion of studies measuring recent mental health service use in active-duty military personnel.
• Exclusion of studies focused solely on retired veterans.

Main Results:

• Twenty-eight studies were included; 12 focused on depression, 16 on any mental health disorder.
• Median period prevalence of mental health service use for depression ranged from 48% (2-12 months).
• Prevalence was higher when diagnostic interviews were used versus screening tools (60% vs. 44%).

Conclusions:

• A significant treatment gap for major depression and mental health disorders exists in military personnel.
• The choice of measurement tool (diagnostic interview vs. screening) impacts the estimated treatment gap size.
• Researchers should exercise caution when using screening tools to avoid overestimating the mental health treatment gap.