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: 7581034
• 负责人: SANDRO MD, MPH, DRPH GALEA
• 金额: $ 63.37万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 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 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7581034
• 关键词: Accounting; Address; Afghanistan; Air; Alcohol or Other Drugs use; Anxiety; Anxiety Disorders; Characteristics; Chronic; Coast Guard; Communities; 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 Health; Mental Health Services; Mental disorders; Methods; Military Personnel; Modeling; Morbidity - disease rate; Natural Disasters; Online Systems; Operative Surgical Procedures; 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; depression; experience; follow-up; health care service utilization; improved; loved ones; member; psychologic; psychological distress; psychosocial; resilience; response; service utilization; social; 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多元因果框架内评估心理健康和心理健康服务的利用率，并在多元因果框架内评估，该储备和国民警卫队在多元因果框架内考虑了生活课程的经验和环境，以及战斗历史，其他储备和国民警卫队和国民警卫队的经验（例如，人类活动）（例如，人类活动）和民用事件体验经验，是精神健康的人，是该小组的精神健康。特别是，我们在这里不仅关注这些力量之间精神疾病和健康服务利用的普遍性和相关性，而且还致力于记录这些力量中精神健康和良好的轨迹。尽管关于现役军事人员的心理健康和心理健康需求的文献越来越多，但这将是我们所知道的最好的研究，它明确地集中在预备役和国民警卫队的经验上。鉴于在伊拉克和阿富汗的恐怖主义战争期间对储备和国民警卫队的越来越依赖，这一点尤其重要。当前在这两个国家中的一个持久自由行动（OEF）或伊拉克自由行动（OIF）的一部分部署已增加了美国储备金和国民警卫队成员的职责，包括经常部署作为对自然灾害的反应的一部分。例如，在对卡特里娜飓风的回应期间，军方部署了72,000名部队，包括50,000名国民警卫队以及海军船和直升机。在这项研究中，我们建议在国民警卫队之间记录心理病理学，健康风险行为和心理健康服务的利用，并确定个人因素（例如社会人口统计学因素，社会支持），储备和国民警卫队的参与，例如服务的时间长度，服务时间长度，单位坐聚会，培训的程度，培训的程度，与家庭/亲人的阶段以及整合的情况相关联（例如，均与生活相关联），以及整合的情况 - 在考虑战斗暴露（例如国际部署，现役战斗）和其他创伤事件经验时，预备役和国民警卫队之间的心理发病轨迹随着时间的推移和国民警卫的轨迹。这项研究对暴露于创伤事件（包括战斗经验和家庭部署），国防军和储备金的培训以及指挥官和军事领导的教育后，对早期干预有影响。在典型的一年中，包括预备役和国民警卫队的许多成员在内，美国军事力量部署在全球100多个国家。在伊拉克和阿富汗的恐怖主义战争中，对储备和国民警卫队的依赖变得越来越大。这项工作的目的是在代表性的储备和国民警卫队样本中评估心理健康和心理健康服务的利用，这些储量和国民警卫队将考虑生活课程的经验和环境，以及战斗历史，其他后备和国民警卫队的经验（例如人道主义活动）以及平民创伤性事件，作为该小组精神健康的决定因素。这项研究可以帮助指导暴露于创伤事件（包括战斗经验和国内部署），军事人员培训以及指挥官和军事领导层的早期干预措施的发展，以提高预备队和国民警卫队之间的韧性。