Patterns and Predictors of Treatment Delay for Mental Disorders in a Nationally Representative, Active Canadian Military Sample

BACKGROUND: Although mental disorders constitute a significant public health problem in military populations, little is known about whether military members seek mental health treatment in a timely manner. OBJECTIVE: The objective of this study was to examine delays in making the initial treatment contact for various mental disorders in a military population. DESIGN: A cross-sectional analysis was conducted using data from the Canadian Community Health Survey-Canadian Forces Supplement. SUBJECTS AND MEASURES: Participants (N = 8441) were assessed for mood and anxiety disorders, using the World Health Organization's Composite International Diagnostic Interview. Those meeting criteria for at least 1 disorder in their lifetime were included in the analyses. RESULTS: :The majority (82%-100%) of military members with a DSM-IV disorder eventually seek treatment. However, there are significant delays in seeking treatment. Median delays for major depressive disorder, generalized anxiety disorder, posttraumatic stress disorder, panic disorder, and social phobia are 3, 3, 7, 8, and 26 years, respectively. For deployment related posttraumatic stress disorder, longer delays are associated with being in an older age cohort, being male, not having comorbid panic disorder, and shorter military service duration. Across all disorders, longer delays are associated with being in an older age cohort, shorter military service duration, and earlier age of onset. CONCLUSIONS: Failure to initiate treatment in a timely manner is a major mental health service access issue in the military context. Interventions that aim to shorten treatment delays are needed and should target military members most at risk for delaying treatment

Mental health · Psychiatry · Sample (material) · Clinical Psychology · Medicine · Mental Health Treatment and Access · Personality Disorders and Psychopathology · Posttraumatic Stress Disorder Research · Psychology

• Influence of Comorbid Mental Disorders on Time to Seeking Treatment for Major Depressive Disorder

  Mark Olfson, Shang-Min Liu et al.•Medical Care•2012

  Incluir item

• The Process Leading to Help Seeking Following Childhood Trauma

  Open Access•Signe Hjelen Stige, Bente Træen et al.•Qualitative Health Research•2013

  Incluir item

• An Introduction to the Bootstrap

  Bradley Efron, Robert Tibshirani et al.•Introduction to the Bootstrap•1994

  Incluir item

• Mental Health Problems, Use of Mental Health Services, and Attrition From Military Service After Returning From Deployment to Iraq or Afghanistan

  Charles W Hoge, Jennifer L Auchterlonie et al.•JAMA•2006

  Incluir item

• Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning From the Iraq War

  Charles S Milliken, Jennifer L Auchterlonie et al.•JAMA•2007

  Incluir item

• Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care

  Charles W Hoge, Carl A Castro et al.•New England Journal of Medicine•2004

  Incluir item

• Nonparametric Estimation from Incomplete Observations

  Edward L Kaplan, Paul Meier•Journal of the American…•1958

  Incluir item

• Failure and Delay in Initial Treatment Contact After First Onset of Mental Disorders in the National Comorbidity Survey Replication

  Philip S Wang, Patricia Berglund et al.•Archives of General Psychiatry•2005

  Incluir item

• Delay of First Treatment of Mental and Substance Use Disorders in Mexico

  Guilherme Borges, Philip S Wang et al.•American Journal of Public Health•2007

  Incluir item

• Twelve Month Use of Mental Health Services in a Nationally Representative, Active Military Sample

  Deniz Fikretoglu, Stéphane Guay et al.•Medical Care•2008

  Incluir item

• Social memory in everyday life

  John J Skowronski, Andrew L Betz et al.•Journal of Personality and Social…•1991

  Incluir item