Online Program

Working toward peace by providing civilian health and mental health services to active duty military personnel- an update

Tuesday, November 5, 2013 : 1:00 p.m. - 1:15 p.m.

Mario Cruz, MD, University of New Mexico, Albuquerque, NM
Howard Waitzkin, MD, PhD, Department of Sociology and Robert Wood Johnson Foundation Center for Health Policy, University of New Mexico, Loves Park, IL
Objective: The increasing health and mental health problems of military personnel have emerged as a major public health epidemic. We present findings from an ongoing effort to identify social variables that mediate health and mental health disorders among active duty GIs and veterans 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 and veteran 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, 36% identified themselves as belonging to a minority group and 20% were female. Depression (71%), PTSD (55%), other anxiety disorder (45%), and Alcohol Use Disorder (31%) were the most common diagnoses. No consistent relationship between race/ethnicity and mental disorders emerged. In multivariate analyses, male gender was significantly and positively associated with an other anxiety disorder diagnosis (p=0.028) while pre-military physical health conditions (p=0.015) and mistrust of the military (p=0.019) were significantly associated with the presence of suicidal ideation. Many clients reported suicidal ideation (88%). Qualitative analyses revealed that clients tended to mistrust the military command to address their health and mental health needs. In follow-up interviews, clients generally expressed satisfaction and gratitude for the civilian services. Conclusion: The continuing and largely favorable results provide a rationale for further assessment of military personnel characteristics who prefer civilian to military services.

Learning Areas:

Advocacy for health and health education
Provision of health care to the public
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the conditions that lead active duty GIs to seek civilian health and mental health services. Discuss the characteristics of GIs who use such civilian services. Analyze the rationale for civilian services as an alternative to the contradictions inherent in military services for active duty GIs. Analyze how such services may contribute to peace.

Keyword(s): Access and Services, Computer-Assisted

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principle of federally funded grants focusing on mental health service delivery and healthcare disparities. Among my scientific interests has been the characterization of difficult to reach and underserved populations as well as incorporating information technology into healthcare service delivery. In addition, I was principally involved in analyzing and interpreting the data for this presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.