Mental Health Utilization Research Study Proposal

Abstract

The U.S. Military has had an increasingly large amount of combat related deployments since the end of the last World War (Bruce, 2010; Kemp, & Bossarte, 2012). Combat related deployments are used on both the small and larger scale to meet the security, sovereignty, and supremacy needs of the United States of America. Accordingly, combat related deployments were utilized in the Vietnam War, the Gulf War, and most recently in the Iraq war and its associated conflict in Afghanistan (Roberts et al., 2011). Those missions or operations and subsequent deployments have increased the prevalence of combat related stressors and traumas (Bruce, 2010), (Kemp, & Bossarte, 2012). The stressors and traumas include such things as seeing other soldiers wounded or killed in action, an enemy firefight (direct weaponized conflict usually with military grade weaponry), witnessing or committing atrocities, receiving fire from rockets, mortars or snipers, and long-range reconnaissance patrols behind enemy lines. These stressors or traumatic events can manifest in dysfunction, personal issues with coping, or mental disorders amongst military members (DSM-5, 2014). Of the various manifestations, one has proven to be extremely prevalent and destructive to military members and their families, that issue is Post-Traumatic Stress Disorder (PTSD) (Bruce, 2010; Kemp, & Bossarte, 2012). PTSD has been shown to have a correlated link with increased risk for Veteran suicide and suicidality (Frueh, et al, 2005;Roberts et al., 2011). In fact, a recent study states that 22 Veterans kill themselves a day and of those numbers, nearly half are suffering from PTSD or a related mental health issue (Bruce, 2010). For racial and ethnic minorities (particularly African Americans and Hispanics women), risk of PTSD is particularly high because increased odds of child maltreatment and witnessing domestic violence in childhood are associated with later odds of developing PTSD. The most devastating factor is that these groups are less likely to seek treatment (Roberts et al., 2011). The lack of “treatment seeking behaviors” by these population groups shown by the results of the study referenced above, provide a stark contrast with the increased availability and ease of access to federal and private mental health care providers. In fact, the increased availability and ease of access to federal and private mental health care providers is on the rise in the United States. In other words, there is increased availability and ease of access to mental health offerings; however, there remain high rates of suicide amongst the largest contingents of minority populations. Some mental health professionals have attributed the earlier mentioned high rates of suicide, particularly amongst minorities, to resistance to utilization of available mental health services (Roberts et al., 2011). To reinforce these claims these same professionals commonly offer the Dept. of Health and Human Services backed complaints and observations, sourced from prominent minority groups. These groups have taken issues with related topics such as limited access (location based) to care, social stigma, incongruent communal values, fear of alienation or unwanted employment bias (military units or employer) (Beals, et al., 2002), (Beckam, et al., 1998). As discussed above, some aspects of military service have been linked to the likelihood of developing PTSD, unwanted stress, and a tendency to amplify underlying mental health issues. These issues have an associated tendency to produce suicidality and suicide amongst Veterans (Roberts et al., 2011). The data also provided information detailing higher than average amounts of PTSD amongst minorities and lower rates of health care utilization. This establishes that there is risk and low utilization; consequently, it’s reasonable to believe that increased utilization would lead to better outcomes. For this and other reasons, the mention of health care utilization is relevant because it is the leading intervention for PTSD and could possibly have mitigating effects on suicidality amongst military members (Beals, et al., 2002), (Beckam, et al., 1998). An exploration of this information on utilization, PTSD and suicidality also helps to place this issue into a context that is worthy of social work research. This is not only because PTSD and its increased association with suicidality has a direct impact on military members. This is also because PTSD and its increased association with suicidality has a direct impact on their family members as well as the whole of society. Based on the issues, facts and available resources mentioned above, I hypothesize that the receipt of web-based mental health therapy will be negatively associated with risk for suicide (Roberts et al., 2011; (Beckam, et al., 1998; Beals, et al., 2002). More specifically, I hypothesize that as the use of the web-based mental health therapy increases, the risk of suicide will decrease (Roberts et al., 2011), (Beckam, et al., 1998; Beals, et al., 2002).