Prevalence, Comorbidity, and Prognosis of Mental Health Among US Veterans

Overview

Journal Am J Public Health

Specialty Public Health

Date 2015 Oct 17

PMID 26474009

Citations 141

Authors

Ranak B Trivedi

Edward P Post

Haili Sun

Andrew Pomerantz

Andrew J Saxon

John D Piette

Charles Maynard

Bruce Arnow

Idamay Curtis

Stephan D Fihn

Karin Nelson

Affiliations

Soon will be listed here.

Abstract

Objectives: We evaluated the association of mental illnesses with clinical outcomes among US veterans and evaluated the effects of Primary Care-Mental Health Integration (PCMHI).

Methods: A total of 4 461 208 veterans were seen in the Veterans Health Administration's patient-centered medical homes called Patient Aligned Care Teams (PACT) in 2010 and 2011, of whom 1 147 022 had at least 1 diagnosis of depression, posttraumatic stress disorder (PTSD), substance use disorder (SUD), anxiety disorder, or serious mental illness (SMI; i.e., schizophrenia or bipolar disorder). We estimated 1-year risk of emergency department (ED) visits, hospitalizations, and mortality by mental illness category and by PCMHI involvement.

Results: A quarter of all PACT patients reported 1 or more mental illnesses. Depression, SMI, and SUD were associated with increased risk of hospitalization or death. PTSD was associated with lower odds of ED visits and mortality. Having 1 or more contact with PCMHI was associated with better outcomes.

Conclusions: Mental illnesses are associated with poor outcomes, but integrating mental health treatment in primary care may be associated with lower risk of those outcomes.

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