Mental health treatment among U.S. military Veterans: Insights from the National Health Interview Survey

Abstract: Background: In the United States (U.S.), the prevalence of anxiety and depression is increasing, yet significant barriers to mental health treatment remain. U.S. military veterans are disproportionately affected by anxiety and depression. Many veterans receive medical care within the Veterans Health Administration (VHA), an integrated healthcare system that has enacted clinical initiatives to reduce barriers to mental health treatment. Objective: We examined associations between VHA healthcare use and receipt of mental health counseling or prescription medication for anxiety or depression. Design: Cross-sectional nationally representative study. Participants: U.S. veterans aged ≥ 18 years with past 12-month healthcare use and anxiety or depression (N = 1,161). Main measures: In the 2019 National Health Interview Survey, veterans were assessed for their use of the VHA (vs. non-VHA healthcare use) and receipt of past 12-month mental health counseling, prescription medication for anxiety, or prescription medication for depression. Key results: Among all veterans with anxiety or depression, only 23% received mental health counseling, while 26% and 23% received prescription medication for anxiety or depression, respectively. Compared to non-VHA veterans, VHA patients were more likely to receive counseling (adjusted odds ratio [aOR] = 6.28, 95% CI: 5.33, 7.40), and prescription medication for anxiety (aOR = 2.03, 95% CI: 1.72, 2.40), or depression (aOR = 2.54, 95% CI: 2.17, 2.97). Conclusions: Among veterans with anxiety or depression, VHA patients were more likely to receive mental health treatment than non-VHA veterans. Findings suggest that veteran use of counseling and psychiatric interventions remains limited, though the integrated healthcare system of the VHA may facilitate access to mental health treatment and provides a framework for non-VHA medical centers to expand access to and improve delivery of mental health services.

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