Tuesday, 25 September 2012

More than half of the returning servicemen and women currently serving in Iraq and Afghanistan have at least one diagnosed mental health condition

Motivation for Mental Health Care – All it Takes is a Phone Call

Phone call
Combat experience during military conflicts places service members at considerable risk for social and mental health disorders, including posttraumatic stress disorder, depression, anxiety, substance abuse, impaired social functioning, and decreased occupational functioning. More than half of the returning servicemen and women currently serving in Iraq and Afghanistan have at least one diagnosed mental health condition. Unfortunately, less than half of these veterans obtain the care they receive. A recent study, however, tapped into a way to motivate these men and women to obtain care: a phone call.

The study, published by the journal General Hospital Psychiatry, evaluated 73 veterans of the military conflicts in Iraq and Afghanistan. Each had been diagnosed with at least one mental health disorder for which treatment was recommended, but none of them were currently receiving treatment. The veterans were randomly assigned to receive either traditional “check-in” phone calls (control group) or motivational interviews (the experimental group) at baseline and 2, 4, and 8 weeks. The interviewers who placed the phone calls to the experimental group held advanced degrees in psychology and received special training in motivational interviewing techniques. Using these techniques, the interviewers expressed empathy and encouraged people to explore their values and behaviors regarding obtaining mental healthcare.

Thirty-four veterans in the experimental group completed the experiment, along with 39 in the control group. In all, 21 (62%) members of the experimental group obtained mental healthcare after the motivational interviews, compared to just 10 (26%) in the control group. The veterans in the experimental group were also more likely to stay in treatment. The experimental group reported less marijuana use during the experiment and less stigma associated with mental health treatment.

Veterans volunteered to serve and protect our country, and the mental health toll that they incur too often comes with the territory of combat duty. The Veterans Administration has made it a priority to care for veterans, especially their mental health, but the service members themselves must be motivated to obtain and engage in care. Failing to receive mental health treatment can lead to chronic mental illness, social and occupational dysfunction, and, too often, suicide. The perception of stigma that accompanies mental healthcare is often cited as a common reason that veterans do not receive care.

Similar motivational techniques have been successfully employed in primary care settings, but few studies have been conducted in the mental health fields. However, these results are promising. If something as simple as a phone call can motivate brave men and women to seek the care they need, then a phone call is what they should get.

References
Hoge CW, Auchterlonie JL, & Milliken CS (2006). Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. JAMA : the journal of the American Medical Association, 295 (9), 1023-32 PMID: 16507803
Hoge CW, Castro CA, Messer SC, McGurk D, Cotting DI, & Koffman RL (2008). Combat duty in Iraq and Afghanistan, mental health problems and barriers to care. U.S. Army Medical Department journal, 7-17 PMID: 20088060
Seal KH, Abadjian L, McCamish N, Shi Y, Tarasovsky G, & Weingardt K (2012). A randomized controlled trial of telephone motivational interviewing to enhance mental health treatment engagement in Iraq and Afghanistan veterans. General hospital psychiatry, 34 (5), 450-9 PMID: 22632925
Seal KH, Cohen G, Bertenthal D, Cohen BE, Maguen S, & Daley A (2011). Reducing barriers to mental health and social services for Iraq and Afghanistan veterans: outcomes of an integrated primary care clinic. Journal of general internal medicine, 26 (10), 1160-7 PMID: 21647750
Image via MalDix / Shutterstock.

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