TY - JOUR
T1 - The effects of age on initiation of mental health treatment after positive PTSD screens among Veterans Affairs primary care patients
AU - Lu, Mary W.
AU - Carlson, Kathleen F.
AU - Duckart, Jonathan P.
AU - Dobscha, Steven K.
N1 - Funding Information:
This work was supported by VA Health Services Research and Development Service (HSR&D) grants REA 06-174 and CDA 08-025 , and the Pacific Northwest Mental Illness Research and Education and Clinical Center . The authors acknowledge Bentson McFarland, M.D., Ph.D.; Jean O'Malley, M.P.H.; Maya O'Neil, M.S., Ph.D.; Alex Linke, B.S.; Molly DeLorit, B.A.; Sondra K. Long, B.A.; and Linda Ganzini, M.D., for their assistance. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.
PY - 2012/11
Y1 - 2012/11
N2 - Objective: The objective was to examine differences by age in mental health treatment initiation in Veterans Health Administration (VA) primary care patients after positive posttraumatic stress disorder (PTSD) screens. Methods: This was a retrospective cohort study of 71,039 veterans who were administered PTSD screens during primary care encounters in 2007 at four Pacific Northwest VA medical center sites and who had no specialty mental health clinic visits or PTSD diagnoses recorded in the year before screening. Main outcome measures were attendance of any specialty mental health clinic visits or receipt of any antidepressant medication in the year after a positive PTSD screen. Results: Older veterans, compared with veterans less than 30 years old, were less likely to attend any specialty mental health visits after positive PTSD screens [adjusted odds ratios (ORs) ranged from .57 to .12, all P< .001], and veterans 75 years and older were less likely to receive any antidepressant medication (adjusted OR=56, P< .001). Conclusions: Initiation of mental health treatment among veterans who screen positive for PTSD varies significantly by age. Further research should examine whether this is due to differences in base rates of PTSD, treatment preferences, provider responses to screens or other age-related barriers to mental health treatment.
AB - Objective: The objective was to examine differences by age in mental health treatment initiation in Veterans Health Administration (VA) primary care patients after positive posttraumatic stress disorder (PTSD) screens. Methods: This was a retrospective cohort study of 71,039 veterans who were administered PTSD screens during primary care encounters in 2007 at four Pacific Northwest VA medical center sites and who had no specialty mental health clinic visits or PTSD diagnoses recorded in the year before screening. Main outcome measures were attendance of any specialty mental health clinic visits or receipt of any antidepressant medication in the year after a positive PTSD screen. Results: Older veterans, compared with veterans less than 30 years old, were less likely to attend any specialty mental health visits after positive PTSD screens [adjusted odds ratios (ORs) ranged from .57 to .12, all P< .001], and veterans 75 years and older were less likely to receive any antidepressant medication (adjusted OR=56, P< .001). Conclusions: Initiation of mental health treatment among veterans who screen positive for PTSD varies significantly by age. Further research should examine whether this is due to differences in base rates of PTSD, treatment preferences, provider responses to screens or other age-related barriers to mental health treatment.
KW - Mass screening
KW - Posttraumatic stress disorders
KW - Veterans/psychology
UR - http://www.scopus.com/inward/record.url?scp=84867862735&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84867862735&partnerID=8YFLogxK
U2 - 10.1016/j.genhosppsych.2012.07.002
DO - 10.1016/j.genhosppsych.2012.07.002
M3 - Article
C2 - 22898446
AN - SCOPUS:84867862735
SN - 0163-8343
VL - 34
SP - 654
EP - 659
JO - General Hospital Psychiatry
JF - General Hospital Psychiatry
IS - 6
ER -