Presentation Title: Employment Status and Mental Health Services Use Among OEF/OIF Veterans and Veterans of Other Eras

Abstract: Background: Mental health disorders have been linked to employment problems for veterans. Previous work has shown that improving mental health conditions, such as depression, can improve veteran employment outcomes. Given the link between improving mental health and employment, increasing access to mental health treatments for veterans is particularly important. The current study investigates how employment status is associated with mental health treatment utilization, comparing OEF/OIF and veterans from other eras.

Methods: Participants were 14162 veterans from six Veterans Affairs medical centers, of whom 4735 (33%) were unemployed. They completed a behavioral health interview, which was then reviewed with their primary care physician for potential follow-up. Mental health treatment utilization was assessed using de-identified patient medical records.

Results: Logistic regressions showed that employed veterans were less likely to receive psychiatric medication (OR: 0.87; CI: 0.80-0.95) and psychotherapy (OR: 0.90; CI: 0.82-0.97) compared to those who were unemployed. Unemployed OEF/OIF veterans were less likely to receive psychiatric medication (OR: 0.57; CI: 0.47-0.67) compared to veterans from other eras.

Conclusions: This is the first study to investigate how employment status is differentially associated with receipt of services comparing OEF/OIF and other veterans. The finding that OEF/OIF status is associated with decreased use of mental health services for unemployed individuals, even after controlling for psychiatric diagnosis, is particularly important, as OEF/OIF veterans are typically younger and employment is crucial to reintegration into civilian life for this group. This study shows that access to mental health services in the VA needs to be improved for unemployed OEF/OIF veterans.

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