(PS7-B37) Combat Veteran Perceived Challenges Across Deployments and Outlook on Professional Care

Combat exposure is associated with higher rates of anxiety, depression, substance use and PTSD symptoms (Donoho et al., 2017; Mustillo et al., 2015). However, underutilization of mental health services is well-documented among veterans and active-duty service members (ADSMs; Hom et al., 2017). One type of treatment barrier involves beliefs regarding mental health providers and the treatments provided (Zinzow et al., 2012). Previous studies have addressed these beliefs by reframing perceptions of treatment and mental health symptoms (Bryan & Morrow, 2011; Adler et al., 2009). The current study examined a combat veteran created questionnaire to evaluate self-reported challenges across deployments and perceptions of treatment.

  

Participants were recruited via social media and identified as veterans or ADSMs who deployed to a combat zone for more than one month. Current analyses used data from 319 veterans and ADSMs (62.4% male) who completed the Veteran Challenges Questionnaire (VCQ). The VCQ was created for combat veterans to indicate which challenges they faced after their first two deployments, as well as those that they currently face. Respondents then ranked these challenges which included a total of 20 emotional, physical, and relational concerns. Additional questions related to military background, mental and physical health, and utilization and perceptions of treatment options were asked as a part of this study.  

 

The endorsed challenges suggest several concerns persist. Challenges such as sleep and controlling emotions were among the top 5 frequently endorsed challenges across timepoints. However, participants consistently ranked moral injury, loss of purpose/meaning, and guilt within the 5 most difficult challenges across time. Although some challenges recurred, 58.3% of participants reported their most difficult challenges differed after their first deployment and 66% reported different challenges after their second deployment.

 

Regarding treatment history, 82% endorsed seeking mental health treatment with 44% currently seeking treatment, 37% completed treatment, and 19% who sought but did not complete treatment. Among those who engaged in mental health treatment, 53% reported they did not trust the mental health professional, 75% felt the treatment plan was not appropriate for their challenges, 82% felt that the mental health professional did not understand their issues and 93% found it hard to talk to someone without military experience.

 

Assessing perceived challenges and treatment experiences of veterans and ADSMs are critical to overcoming attitudinal barriers to treatment engagement. Using the VCQ allows for a veteran-centered assessment which clinicians may use to tailor treatment approaches. Utilizing a veteran-centered approach may also signify trustworthiness, compassion, and knowledge, thus reducing attitudinal barriers to care.