Abstract
Service members (SM) are at increased risk of psychiatric conditions, including suicide, yet research indicates SMs believe seeking mental health treatment may negatively impact their military careers, despite a paucity of research examining actual career impacts. This study examined the link between seeking outpatient mental health (MH) treatment and military career impacts within the United States Marine Corps. In Phase 1, a retrospective medical record review of outpatient MH treatment-seeking Marines (N = 38) was conducted. In Phase 2, a sample of outpatient MH treatment-seeking Marines (N = 40) was matched to a non-treatment-seeking sample of Marines (N = 138) to compare career-progression. In Phase 1, there were no significant links between demographic, military, and clinical characteristics and referral source or receipt of career-affecting treatment recommendations. In Phase 2, MH treatment-seeking Marines in outpatient settings were more likely than matched controls to be separated from the military (95.0% versus 63.0%, p = 0.002), but no more likely to experience involuntary separation. MH treatment-seeking Marines were more likely to have documented legal action (45.0% versus 23.9%, p = 0.008) and had a shorter time of military service following the index MH encounter than matched controls (p < 0.001). Clinical, anti-stigma, and suicide prevention policy implications are discussed.
Highlights
Research has shown that military service members (SM) are at increased risk of psychiatric conditions including depression, post-traumatic stress disorder (PTSD), sleep problems, and suicide [1,2].Suicide accounted for 28.1% of all deaths that occurred in the United States (U.S.) armed forces in 2013, making it a leading cause of death among military personnel [3]
Limited by the small sample size and lack of statistical power, results of the current study suggest that Marines who self-refer to mental health treatment, presumably before problems escalate, may be less likely to receive potentially career-impacting treatment recommendations
This study provides initial empirical evidence of the association between seeking outpatient mental health care within the military system and potential military career impacts within the Marine Corps
Summary
Research has shown that military service members (SM) are at increased risk of psychiatric conditions including depression, post-traumatic stress disorder (PTSD), sleep problems, and suicide [1,2]. Suicide accounted for 28.1% of all deaths that occurred in the United States (U.S.) armed forces in 2013, making it a leading cause of death among military personnel [3]. Rates of suicide among U.S Marines have been among the highest within the service branches since 2001, increasing to a rate of 21.2 per. 100,000 people in 2015 [4,5]. Disclosure of suicide ideation (SI) or other psychiatric problems is difficult when the consequences, including being forced to undergo a psychological. Public Health 2018, 15, 828; doi:10.3390/ijerph15040828 www.mdpi.com/journal/ijerph
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