Mental Health Service Utilization by Iraq and Afghanistan Veterans After Entry Into PTSD Specialty Treatment

Objective: Use of care by Iraq and Afghanistan veterans was examined after entry into a U.S. Department of Veterans Affairs (VA) specialty outpatient program for treatment of posttraumatic stress disorder (PTSD). Those who had received mental health care before entry (continuing patients) were compared with those who had not (new patients). Methods: Regression analyses compared veterans' retention in PTSD programs in the 180 days after program entry for new patients (N=172) and continuing patients (N=422). Two retention measures, total visits and completion of nine or more visits, were developed from VA administrative data. Results: New patients completed fewer PTSD visits than did continuing patients (5.2 +/- 9.5 versus 8.3 +/- 14.3; incidence risk ratio=.91, 95% confidence interval [CI] =.85.97) and were also less likely to complete nine or more visits (OR=.81, CI=.68.97). Conclusions: Contact with providers before entering PTSD specialty care may facilitate veterans' treatment engagement, suggesting the value of repeated attempts at engaging such veterans in treatment.