Postrehabilitation Mental Health Treatment Utilization in Veterans With Traumatic Brain Injury: A VA TBI Model Systems Study

Objective To identify preinjury variables related to mental health treatment utilization at 2 years post-traumatic brain injury (TBI). Setting Veterans Affairs (VA) TBI Model Systems includes 5 VA Polytrauma Rehabilitation Centers. Participants Veterans and service members enrolled in TBI Model Systems who completed the year 2 follow-up assessment and provided mental health information. Sample was largely male (97%) and White (72%), with median age of 30 years. Design Participants with elevated mental health symptoms were identified by measures of depression, anxiety, and posttraumatic distress; suicide attempt in the past year; or problematic substance use in the past year. Forty-seven percent of participants had elevated mental health symptoms at 2 years postinjury. Among those with elevated symptoms, comparisons were made between those who sought mental health treatment in past year and those who did not. Main measures Demographic, historic, environmental, psychological/mental health, and injury/rehabilitation variables. Results Within the sample, 23% denied utilizing mental health services. Nonutilizers were more likely to deny a preinjury mental health treatment history, to report problematic substance use at year 2, and to report lower levels of internalizing symptoms than the treatment utilizers. Conclusion Veterans and service members with elevated mental health symptoms may require tailored tactics to promote treatment utilization post-TBI.