Civilian health and mental health services for active duty military personnel

Objective: The increasing health and mental health problems of military personnel have emerged as a major public health epidemic. We attempted to identify social variables that mediate health and mental health disorders among active duty GIs and to assess whether civilian services offered a viable alternative to military services.

Methods: Our sample was drawn from the clients of a nationwide network of civilian physicians and mental health service providers (the Civilian Medical Resources Network) who offered their services to active-duty military personnel. Using a multi-method approach, we conducted quantitative and qualitative analysis of data collected during intake and follow-up interviews.

Results: Among clients, 40% identified themselves as belonging to a minority group. Depression, anxiety, and PTSD were the most common diagnoses. No consistent relationship between race/ ethnicity and mental disorders emerged. In multivariate analyses, lower rank (p=0.002), pre-military physical health conditions (p=0.000), and history of self harm (p=0.000) were significantly associated with the presence of suicidal ideation. Few clients (3.6%) reported no suicidal ideation. Qualitative analyses showed that clients tended to view military health and mental health personnel as unwilling or unable to address their needs, mainly due to the professionals' conflicting responsibilities to clients and to the military command (the problem of “double agency”). In follow-up interviews, clients generally expressed satisfaction and gratitude for the civilian services.

Conclusion: These largely favorable results provide a rationale for further assessment of civilian services for military personnel.