PMID- 31537560
OWN - NLM
STAT- MEDLINE
DCOM- 20200928
LR  - 20200928
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 9
IP  - 9
DP  - 2019 Sep 18
TI  - Differences between the Canadian military's Regular and Reserve Forces in 
      perceived need for care, mental health services use and perceived sufficiency of 
      care: a cross-sectional survey.
PG  - e028849
LID - 10.1136/bmjopen-2018-028849 [doi]
LID - e028849
AB  - OBJECTIVE: The primary objective was to explore differences in perceived need for 
      care (PNC), mental health services use (MHSU) and perceived sufficiency of care 
      (PSC) between Canadian Armed Forces Regular Force (RegF) and Reserve Force (ResF) 
      personnel with an objective need for mental health services. DESIGN: Data came 
      from the 2013 Canadian Armed Forces Mental Health Survey, a cross-sectional 
      survey of serving personnel (n=72 629). Analyses were among those with an 
      Afghanistan deployment and an identified mental disorder (population n=6160; 
      sampled n=868). Logistic regression compared PNC, MHSU and PSC between RegF and 
      ResF. Covariate-adjusted marginal prevalence difference estimates were computed. 
      PRIMARY OUTCOME MEASURE: The primary outcomes were PNC, MHSU and PSC. Each had 
      three service categories, including an aggregate 'any' of the three: (1) 
      information about problems, treatments or services; (2) medication and (3) 
      counselling. RESULTS: ResF had an 10.5% (95% CI -16.7% to -4.4%) lower perceived 
      need for medication services but PNC differences were not significant for other 
      service categories. MHSU tended to be lower for ResF; 9.1% (95%CI -15.5% to 
      -2.6%) lower for medication, 5.4% (95% CI -11.5% to 0.7%) lower, with marginal 
      significance, for counselling and 11.3% (95% CI -17.3% to -5.2%) lower for the 
      'any' service category. Additionally, ResF tended to have a lower fully met need 
      for care; 13.4% (95% CI -22.1% to -4.6%) lower for information, 15.3% (95% CI 
      -22.9% to -7.6%) lower for counselling and 14.6% (95% CI -22.4% to -6.8%) lower 
      for the 'any' service category. CONCLUSIONS: Our findings suggest MHSU and PSC 
      differences between Canadian RegF and ResF personnel that are not fully accounted 
      for by PNC differences. Deficits in ResF members' perceptions of the sufficiency 
      of information services and counselling services suggest perceived, or 
      experienced, barriers to care beyond any PNC barriers. Additional research 
      assessing barriers to mental healthcare is warranted.
CI  - (c) Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Boulos, David
AU  - Boulos D
AUID- ORCID: 0000-0001-7585-0681
AD  - Directorate of Mental Health, Canadian Forces Health Services Group, Ottawa, 
      Ontario, Canada david.boulos@forces.gc.ca.
FAU - Fikretoglu, Deniz
AU  - Fikretoglu D
AD  - Defence Research and Development Canada, Toronto, Ontario, Canada.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190918
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Afghan Campaign 2001-
MH  - Alcoholism/therapy
MH  - Anxiety Disorders/therapy
MH  - *Attitude to Health
MH  - Canada
MH  - Cross-Sectional Studies
MH  - Depressive Disorder, Major/therapy
MH  - Female
MH  - *Health Services Needs and Demand
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Mental Disorders/*therapy
MH  - Mental Health Services/*statistics & numerical data
MH  - Middle Aged
MH  - Military Personnel/*psychology
MH  - Panic Disorder/therapy
MH  - Patient Satisfaction
MH  - Stress Disorders, Post-Traumatic/therapy
MH  - Young Adult
PMC - PMC6756430
OTO - NOTNLM
OT  - health services administration & management
OT  - mental health
OT  - military
COIS- Competing interests: Both DB and DF report that they are employees of the 
      Canadian Department of National Defence and funding for this research came via 
      this federal government department.
EDAT- 2019/09/21 06:00
MHDA- 2020/09/29 06:00
PMCR- 2019/09/18
CRDT- 2019/09/21 06:00
PHST- 2019/09/21 06:00 [entrez]
PHST- 2019/09/21 06:00 [pubmed]
PHST- 2020/09/29 06:00 [medline]
PHST- 2019/09/18 00:00 [pmc-release]
AID - bmjopen-2018-028849 [pii]
AID - 10.1136/bmjopen-2018-028849 [doi]
PST - epublish
SO  - BMJ Open. 2019 Sep 18;9(9):e028849. doi: 10.1136/bmjopen-2018-028849.