Researchers compared rates of PTSD medication and psychotherapy treatment utilization between military veterans and non-veterans. Analysis of data from a national well-being survey indicated 56% of veterans and 86% of nonveterans received no treatment, among other findings. “This study represents the first known study to investigate PTSD medication and psychotherapy utilization among veterans and nonveterans in a nationally representative population-based sample,” according to Rachel M. Ranney, PhD, San Francisco VA Health System, along with colleagues Shira Maguen, PhD, and Nicholas Holder, PhD; as well as Paul A. Bernhard, BA, and Aaron I. Schneiderman, PhD, Veterans Health Administration; Dawn E. Vogt, PhD, VA Boston Healthcare System; and John R. Blosnich, PhD, MPH, University of Southern California.
Variety of factors correlate with treatment utilization rates
According to previous research by the US Department of Veterans Affairs, veterans who take advantage of PTSD treatment tend to be individuals with higher disease severity and female, while racial minority veterans have much lower rates of psychotherapy utilization. Among nonveterans, studies have shown that factors such as race, employment status, age, and health insurance status may play a part in treatment utilization, though correlations are unclear.
This study was the first to use a survey sample on a national scale. Ranney and her colleagues gathered data from more than 2,700 individuals — 2,508 veterans and 267 nonveterans who met the criteria for having PTSD — who participated in a VA-sponsored survey on the well-being of 9/11 veterans and nonveterans. Data was collected from April to August 2018.
While the majority of both veterans and nonveterans received no treatment, veterans were much more likely to receive both medication and psychotherapy than nonveterans. Findings also show that Veterans Affairs health insurance coverage was strongly associated with treatment utilization. In addition, Black veterans were less likely than White veterans to receive any form of treatment.
Factors determining uptake of PTSD treatment by nonveterans included marital status and history of sexual trauma. Married or divorced nonveterans received PTSD medication at much higher rates than the non-married (married or partnered veterans were also more likely to receive medication). Nonveterans reporting a history of sexual trauma were most likely to receive PTSD psychotherapy.
Patient education on treatments and symptoms is critical to increase utilization
The study clearly demonstrates that most individuals do not receive PTSD treatment, and that efforts to encourage utilization are sorely needed. In particularly, better “understanding of treatment barriers and facilitators for both veterans and nonveterans is needed to improve intervention reach,” adds Ranney. A particular focus on improving access to psychotherapy as well as care barriers for groups least likely to seek out and receive treatment could be especially helpful.
