Perceived Need for and Perceived Sufficiency of Mental Health Care in the Canadian Armed Forces: Changes in the Past Decade and Comparisons to the General Population

Objectives: Failure to perceive need for care (PNC) is the leading barrier to accessing mental health care. After accessing care, many individuals perceive that their needs were unmet or only partially met, an additional problem related to perceived sufficiency of care (PSC). The Canadian Armed Forces (CAF) invested heavily in workplace mental health in the past decade to improve PNC/PSC; yet, the impact of these investments remains unknown. To assess the impact of these investments, this study 1) captures changes in PNC/PSC over the past decade in the CAF and 2) compares current PNC/PSC between the CAF and civilians. Methods: Data were drawn from the 2013 and 2002 CAF surveys and the 2012 civilian mental health survey (total N = approximate to 40 000), conducted by Statistics Canada using similar methodology. Exclusions were applied to the civilian sample to make them comparable to the military sample. Prevalence rates for No need, Need met, Need partially met, and Need unmet categories across service types (Information, Medication, Counselling and therapy, Any services) were calculated and compared between 1) the 2 CAF surveys and 2) the 2013 CAF and 2012 civilian surveys after sample matching. Results: Reports of Any need and Need met were higher in the CAF in 2013 than in 2002 by approximately 6% to 8% and 2% to 8%, respectively, and higher in the CAF than in civilians by 3% to 10% and 2% to 8%, respectively. Conclusions: These results suggest that investments in workplace mental health, such as those implemented in the CAF, can lead to improvements in recognizing the need for care (PNC) and subsequently getting those needs met (PSC). Objectif: Le manque de perception d un besoin de soins (PBS) est le principal obstacle a l'acces aux soins de sante mentale. Apres avoir accede aux soins, de nombreuses personnes percoivent que leurs besoins n'etaient pas combles ou qu'ils l'etaient seulement partiellement, un probleme additionnel lie a la perception de la suffisance des soins (PSS). Les Forces armees canadiennes (FAC) ont investi lourdement dans la sante mentale en milieu de travail ces dix dernieres annees afin d'ameliorer les PBS/PSS; et pourtant, l'effet de ces investissements demeure inconnu. Afin d'evaluer l'effet de ces investissements, cette etude : 1) repere les changements de PBS/PSS au cours de la derniere decennie dans les FAC, et 2) compare les PBS/PSS actuelles entre les FAC et les civils. Methode: Les donnees ont ete tirees des enquetes sur la sante mentale de 2013 et 2002 des FAC, et de l'enquete civile de 2012 (total N approximate to 40000), menees par Statistique Canada a l'aide de methodologie semblable. Des exclusions ont ete appliquees a l'echantillon civil pour qu'il soit comparable a celui des militaires. Les taux de prevalence des categories Aucun besoin, Besoin comble, Besoin partiellement comble, et Besoin non comble dans tous les types de services (Information, Medication, Consultation, Autre) ont ete calcules et compares entre 1) les deux enquetes des FAC; et 2) l'enquete de 2013 des FAC et l'enquete civile de 2012, apres comparaison d'echantillons. Resultats: Les declarations d'Aucun besoin et de Besoin comble etaient plus elevees dans les FAC en 2013 qu'en 2002, d'environ 6-8% et 2-8%, respectivement, et plus elevees dans les FAC que chez les civils, de 3-10% et 2-8%, respectivement. Conclusions: Ces resultats suggerent que les investissements en sante mentale en milieu de travail, comme ceux mis en OEuvre par les FAC, peuvent entrainer des ameliorations de la reconnaissance du besoin de soins (PBS) et subsequemment, que ces besoins soient combles (PSS).