Mental Health and Service Utilization Among Reserve and National Guard Forces

预备役和国民警卫队的心理健康和服务利用

• 批准号: 8064355
• 负责人: SANDRO MD, MPH, DRPH GALEA
• 金额: $ 64.99万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8064355
• 关键词: Accounting; Address; Afghanistan; Air; Alcohol or Other Drugs use; Anxiety; Anxiety Disorders; Characteristics; Chronic; Coast Guard; Communities; Comorbidity; Country; Dependence; Development; Disasters; Domestic Violence; Early treatment; Economics; Education; Event; Exhibits; Exposure to; Family; Financial Support; Freedom; Functional disorder; Gender; Goals; Growth; Health; Health behavior; Helicopter; Home environment; Human Resources; Hurricane; Individual; Intention; International; Interview; Iraq; Leadership; Length; Life; Life Cycle Stages; Linear Models; Literature; Logistics; Low Prevalence; Marines; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Methods; Military Personnel; Modeling; Morbidity - disease rate; Natural Disasters; Online Systems; Participant; Pattern; Personal Satisfaction; Persons; Post-Traumatic Stress Disorders; Prevalence; Prevalence Study; Psyche structure; Psychopathology; Readiness; Recording of previous events; Recruitment Activity; Recurrence; Reliance; Resistance; Resolution; Resources; Risk; Risk Behaviors; Sampling; Services; Shapes; Shipping; Ships; Social Health Services; Social Work; Social support; Staging; Surveys; Techniques; Telephone; Terrorism; Testing; Time; Training; Trauma; War; Woman; Work; Writing; cohesion; cohort; combat; experience; follow-up; health care service utilization; improved; loved ones; member; operation; psychologic; psychological distress; psychosocial; resilience; response; service utilization; stressor

DESCRIPTION (provided by applicant): The purpose of this work is to assess mental health and mental health service utilization over time among a representative sample of Reserves and National Guard within a multivariate causal framework that takes into account life course experiences and circumstances together with combat history, other Reserve and National Guard experience (e.g. humanitarian activity) and civilian traumatic event experiences as determinants of mental health in this group. In particular we focus here not only on documenting the prevalence and correlates of mental illness and health service utilization among these forces, but also on documenting the trajectories of mental health and well- being over time among these forces. Although there is a growing literature about the mental health and mental health needs of active duty military personnel, this would be the first study, as best we know, that has focused explicitly on the experience of the Reserve and National Guard. This is particularly important given the growing reliance on Reserve and National Guard forces during the war against terrorism in Iraq and Afghanistan. Current deployment to one of these two countries as parts of Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF) have added to the duties of members of the Reserve and National Guard forces in the US, including frequently deployment as part of the response to natural disasters. For example, during the response to Hurricane Katrina, the military deployed 72,000 forces including 50,000 National Guard as well as Navy ships and helicopters. In this study we propose to document psychopathology, health risk behavior, and mental health service utilization among National Guard and to identify personal factors (e.g., sociodemographic factors, social supports), Reserve and National Guard involvement (e.g., length of time in service, unit cohesion, extent of training, rank, separation from family/loved ones), and life circumstances (e.g., integration of regular work circumstances) that are associated with both stage- sequential psychological morbidity and trajectories of psychological morbidity over time among Reserve and National Guards when accounting for combat exposures (e.g., international deployment, active duty combat) and other traumatic event experiences. This study has implications for early intervention after exposure to traumatic events (including combat experiences and domestic deployment), training of National Guards and Reserves, and education of commanding officers and military leadership. In a typical year, US military forces, including many members of the Reserve and National Guard, are deployed in over 100 countries around the world. The reliance on Reserve and National Guard forces has become ever greater during the war against terrorism in Iraq and Afghanistan. The purpose of this work is to assess mental health and mental health service utilization over time among a representative sample of Reserves and National Guard that takes into account life course experiences and circumstances together with combat history, other Reserve and National Guard experience (e.g. humanitarian activity), and civilian traumatic event experiences as determinants of mental health in this group. This study can help guide the development of early intervention after exposure to traumatic events (including combat experiences and domestic deployment), training of military personnel, and education of commanding officers and military leadership about ways to improve resilience among Reserve and National Guard forces.

描述（由申请人提供）：这项工作的目的是在考虑生命历程经历和情况以及战斗的多变量因果框架内，评估预备役和国民警卫队代表性样本随时间的心理健康和心理健康服务利用率历史、其他预备役和国民警卫队经历（例如人道主义活动）和平民创伤事件经历是该群体心理健康的决定因素。特别是，我们在这里不仅关注记录这些力量中精神疾病和卫生服务利用的患病率和相关性，而且还记录这些力量随着时间的推移心理健康和福祉的轨迹。尽管关于现役军人心理健康和心理健康需求的文献越来越多，但据我们所知，这将是第一项明确关注预备役和国民警卫队经验的研究。鉴于在伊拉克和阿富汗的反恐战争中对预备役部队和国民警卫队的依赖日益增加，这一点尤为重要。目前作为持久自由行动 (OEF) 或伊拉克自由行动 (OIF) 的一部分部署到这两个国家之一，增加了美国预备役和国民警卫队成员的职责，包括作为响应的一部分频繁部署到自然灾害。例如，在应对卡特里娜飓风期间，军方部署了 72,000 名部队，其中包括 50,000 名国民警卫队以及海军舰艇和直升机。在这项研究中，我们建议记录国民警卫队的精神病理学、健康风险行为和心理健康服务利用情况，并确定个人因素（例如社会人口因素、社会支持）、预备役和国民警卫队的参与程度（例如服役时间长度、单位凝聚力、培训程度、等级、与家人/亲人的分离）以及与阶段性心理发病率和心理轨迹相关的生活环境（例如，正常工作环境的整合）。在考虑战斗暴露（例如国际部署、现役战斗）和其他创伤性事件经历时，预备役和国民警卫队随时间的发病率。这项研究对于经历创伤性事件（包括战斗经历和国内部署）后的早期干预、国民警卫队和预备役人员的培训以及指挥官和军事领导层的教育具有重要意义。通常情况下，美国军队（包括许多预备役部队和国民警卫队成员）部署在全球 100 多个国家。在伊拉克和阿富汗的反恐战争中，对预备役部队和国民警卫队的依赖变得越来越大。这项工作的目的是评估预备役和国民警卫队代表性样本随时间的心理健康和心理健康服务利用率，其中考虑了生命历程经历和环境以及战斗历史、其他预备役和国民警卫队经验（例如人道主义活动） ），以及平民创伤事件经历作为该群体心理健康的决定因素。这项研究可以帮助指导在经历创伤性事件（包括战斗经验和国内部署）后进行早期干预、军事人员培训以及对指挥官和军事领导层进行关于如何提高预备役和国民警卫队复原力的教育。