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Predictors of Likelihood and Intensity of Past-Year Mental Health Service Use in an Active Canadian Military Sample

Dr. Fikretoglu is affiliated with Defense Research and Development Canada, 1133 Sheppard Ave., West, P.O. Box 2000, Toronto, Ontario, Canada M3M 3B9 (e-mail: dfikreto{at}yahoo.com). Dr. Elhai is with the Disaster Mental Health Institute, University of South Dakota, Vermillion. Dr. Liu is with the Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada. Dr. Richardson is with the Operational Stress Injury Clinic, Parkwood Hospital, St. Joseph's Healthcare, London, Ontario, Canada. Dr. Pedlar is with the Research Directorate, Veterans Affairs Canada, Charlottetown, Prince Edward Island.

OBJECTIVE: This study examined associations between sociodemographic, military, and psychiatric need variables and past-year mental health service use among active Canadian military members. The likelihood and intensity of services were examined across two provider types—mental health providers and medical providers. METHODS: Data were drawn from the first epidemiological survey of mental health in the Canadian Forces, conducted by Statistics Canada in 2002. Survey instruments included the Composite International Diagnostic Interview, which was used to assess mental health and service use. RESULTS: Of the 8,441 military members who participated in the survey, 14.5% (N=1,220) met criteria for having a mental disorder in the past year. However, of the 8,441 only 9.1% (N=767) contacted a mental health provider in the past year for mental health problems; even fewer (N=539, 6.4%) contacted a medical provider. Across the two provider types, the majority of those seeing a provider reported five or fewer mental health visits in the past year. In univariate and multivariate analyses across the two provider types, psychiatric need variables were consistently associated with both greater service use likelihood and intensity. In multivariate analyses, lower military rank was consistently associated with both greater service use likelihood and intensity. CONCLUSIONS: Of the entire military sample, only a small percentage used mental health services. The observed associations between military and psychiatric need variables and mental health service use in this study should be used by military health care providers and administrators to increase mental health service use among those most at risk of not using services.

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