Newswise — January 18, 2023 – Despite widespread efforts by the Veterans Affairs administration, PTSD treatment utilization among military veterans and nonveterans remains low, reports a study published in the February issue of Medical Care, an official publication of the Medical Care section of the American Public Health Association. The journal is published in the Lippincott portfolio by Wolters Kluwer.
Researchers compared rates of PTSD medication and psychotherapy treatment utilization between military veterans and non-veterans. Analysis of data from a national well-being survey indicated 56% of veterans and 86% of nonveterans received no treatment, among other findings. “This study represents the first known study to investigate PTSD medication and psychotherapy utilization among veterans and nonveterans in a nationally representative population-based sample,” according to Rachel M. Ranney, PhD, San Francisco VA Health System, along with colleagues Shira Maguen, PhD, and Nicholas Holder, PhD; as well as Paul A. Bernhard, BA, and Aaron I. Schneiderman, PhD, Veterans Health Administration; Dawn E. Vogt, PhD, VA Boston Healthcare System; and John R. Blosnich, PhD, MPH, University of Southern California.
Variety of factors correlate with treatment utilization rates.
According to previous research by the US Department of Veterans Affairs, veterans who take advantage of PTSD treatment tend to be individuals with higher disease severity and female, while racial minority veterans have much lower rates of psychotherapy utilization. Among nonveterans, studies have shown that factors such as race, employment status, age, and health insurance status may play a part in treatment utilization, though correlations are unclear.
This study was the first to use a survey sample on a national scale. Ranney and her colleagues gathered data from more than 2,700 individuals—2,508 veterans and 267 nonveterans who met the criteria for having PTSD—who participated in a VA-sponsored survey on the well-being of 9/11 veterans and nonveterans. Data was collected from April to August 2018.
While the majority of both veterans and nonveterans received no treatment, veterans were much more likely to receive both medication and psychotherapy than nonveterans. Findings also show that Veterans Affairs health insurance coverage was strongly associated with treatment utilization. In addition, Black veterans were less likely than White veterans to receive any form of treatment.
Factors determining uptake of PTSD treatment by nonveterans included marital status and history of sexual trauma. Married or divorced nonveterans received PTSD medication at much higher rates than the non-married (married or partnered veterans were also more likely to receive medication). Nonveterans reporting a history of sexual trauma were most likely to receive PTSD psychotherapy.
Patient education on treatments and symptoms is critical to increase utilization
The study clearly demonstrates that most individuals do not receive PTSD treatment, and that efforts to encourage utilization are sorely needed. In particularly, better “understanding of treatment barriers and facilitators for both veterans and nonveterans is needed to improve intervention reach,” adds Ranney. A particular focus on improving access to psychotherapy as well as care barriers for groups least likely to seek out and receive treatment could be especially helpful.
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About Medical Care
Medical Care is the official journal of the Medical Care Section of the American Public Health Association. Rated as one of the top ten journals in healthcare administration, Medical Care is devoted to all aspects of the administration and delivery of healthcare. This scholarly journal publishes original, peer-reviewed papers documenting the most current developments in the rapidly changing field of healthcare. This timely journal reports on the findings of original investigations into issues related to the research, planning, organization, financing, provision, and evaluation of health services. In addition, numerous special supplementary issues that focus on specialized topics are produced with each volume.
About the Medical Care section of the American Public Health Association
Founded in 1948, the Medical Care Section is guided by the public health ideal that we must act collectively as a society to assure conditions in which people can be healthy. It is committed to improving the nation’s health through practice, research, education and policy action. The Medical Care Section has generated several APHA presidents, and Medical Care is the premier clinical health services research journal in the world.
The section explores the organization and practice of medical care in the U.S. and elsewhere as well as the social, economic and environmental conditions that influence health. They advocate for strengthening and assuring the conditions that preserve and enhance health as well as a medical care system that assures high-quality care, accessible preventive medicine and cultural sensitivity for all. This as attainable through equitable public financing, careful monitoring and feedback of performance, and wise allocation of resources under public leadership.
The American Public Health Association champions the health of all people and all communities. We are the only organization that combines a 150-year perspective, a broad-based member community and the ability to influence federal policy to improve the public’s health. Learn more at www.apha.org.
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