Literature DB >> 21245086

Effectiveness of mental health screening and coordination of in-theater care prior to deployment to Iraq: a cohort study.

Christopher H Warner1, George N Appenzeller, Jessica R Parker, Carolynn M Warner, Charles W Hoge.   

Abstract

OBJECTIVE: The authors assessed the effectiveness of a systematic method of predeployment mental health screening to determine whether screening decreased negative outcomes during deployment in Iraq's combat setting.
METHOD: Primary care providers performed directed mental health screenings during standard predeployment medical screening. If indicated, on-site mental health providers assessed occupational functioning with unit leaders and coordinated in-theater care for those cleared for deployment. Mental health-related clinical encounters and evacuations during the first 6 months of deployment in 2007 were compared for 10,678 soldiers from three screened combat brigades and 10,353 soldiers from three comparable unscreened combat brigades.
RESULTS: Of 10,678 soldiers screened, 819 (7.7%, 95% confidence interval [CI]=7.2-8.2) received further mental health evaluation; of these, 74 (9.0%, 95% CI=7.1-11.0) were not cleared to deploy and 96 (11.7%, 95% CI=9.5-13.9) were deployed with additional requirements. After 6 months, soldiers in screened brigades had significantly lower rates of clinical contacts than did those in unscreened brigades for suicidal ideation (0.4%, 95% CI=0.3-0.5, compared with 0.9%, 95% CI=0.7-1.1), for combat stress (15.7%, 95% CI=15.0-16.4, compared with 22.0%, 95% CI=21.2-22.8), and for psychiatric disorders (2.9%, 95% CI=2.6-3.2, compared with 13.2%, 95% CI=12.5-13.8), as well as lower rates of occupational impairment (0.6%, 95% CI=0.4-0.7, compared with 1.8%, 95% CI=1.5-2.1) and air evacuation for behavioral health reasons (0.1%, 95% CI=0.1-0.2, compared with 0.3%, 95% CI=0.2-0.4).
CONCLUSIONS: Predeployment mental health screening was associated with significant reductions in occupationally impairing mental health problems, medical evacuations from Iraq for mental health reasons, and suicidal ideation. This predeployment screening process provides a feasible system for screening soldiers and coordinating mental health support during deployment.

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Year:  2011        PMID: 21245086     DOI: 10.1176/appi.ajp.2010.10091303

Source DB:  PubMed          Journal:  Am J Psychiatry        ISSN: 0002-953X            Impact factor:   18.112


  25 in total

1.  Suicide Attempts in the US Army During the Wars in Afghanistan and Iraq, 2004 to 2009.

Authors:  Robert J Ursano; Ronald C Kessler; Murray B Stein; James A Naifeh; Pablo A Aliaga; Carol S Fullerton; Nancy A Sampson; Tzu-Cheg Kao; Lisa J Colpe; Michael Schoenbaum; Kenneth L Cox; Steven G Heeringa
Journal:  JAMA Psychiatry       Date:  2015-09       Impact factor: 21.596

2.  Advances and controversies in military posttraumatic stress disorder screening.

Authors:  Daniel J Lee; Christopher H Warner; Charles W Hoge
Journal:  Curr Psychiatry Rep       Date:  2014-09       Impact factor: 5.285

3.  Suicidal ideation among young Afghanistan/Iraq War Veterans and civilians: Individual, social, and environmental risk factors and perception of unmet mental healthcare needs, United States, 2013.

Authors:  Joseph Logan; Amy Bohnert; Erica Spies; Mary Jannausch
Journal:  Psychiatry Res       Date:  2016-08-26       Impact factor: 3.222

4.  Medically Documented Suicide Ideation Among U.S. Army Soldiers.

Authors:  Robert J Ursano; Ronald C Kessler; Murray B Stein; James A Naifeh; Matthew K Nock; Pablo A Aliaga; Carol S Fullerton; Gary H Wynn; Tsz Hin Hinz Ng; Hieu M Dinh; Nancy A Sampson; Tzu-Cheg Kao; Michael Schoenbaum; James E McCarroll; Kenneth L Cox; Steven G Heeringa
Journal:  Suicide Life Threat Behav       Date:  2016-11-29

5.  Understanding the elevated suicide risk of female soldiers during deployments.

Authors:  A E Street; S E Gilman; A J Rosellini; M B Stein; E J Bromet; K L Cox; L J Colpe; C S Fullerton; M J Gruber; S G Heeringa; L Lewandowski-Romps; R J A Little; J A Naifeh; M K Nock; N A Sampson; M Schoenbaum; R J Ursano; A M Zaslavsky; R C Kessler
Journal:  Psychol Med       Date:  2014-10-31       Impact factor: 7.723

6.  Early First Deployment and Risk of Suicide Attempt Among First-term Enlisted Soldiers in the U.S. Army.

Authors:  James A Naifeh; Robert J Ursano; Ronald C Kessler; Pablo A Aliaga; Holly B Herberman Mash; Carol S Fullerton; Tsz Hin Hinz Ng; Hieu M Dinh; Oscar I Gonzalez; Cara M Stokes; Gary H Wynn; Tzu-Cheg Kao; Nancy A Sampson; Murray B Stein
Journal:  Suicide Life Threat Behav       Date:  2019-09-23

7.  Pre-deployment Year Mental Health Diagnoses and Treatment in Deployed Army Women.

Authors:  Nikki R Wooten; Rachel Sayko Adams; Beth A Mohr; Diana D Jeffery; Wendy Funk; Thomas V Williams; Mary Jo Larson
Journal:  Adm Policy Ment Health       Date:  2017-07

8.  Sociodemographic and career history predictors of suicide mortality in the United States Army 2004-2009.

Authors:  S E Gilman; E J Bromet; K L Cox; L J Colpe; C S Fullerton; M J Gruber; S G Heeringa; L Lewandowski-Romps; A M Millikan-Bell; J A Naifeh; M K Nock; M V Petukhova; N A Sampson; M Schoenbaum; M B Stein; R J Ursano; S Wessely; A M Zaslavsky; R C Kessler
Journal:  Psychol Med       Date:  2014-09       Impact factor: 7.723

9.  Barriers to Initiating and Continuing Mental Health Treatment Among Soldiers in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS).

Authors:  James A Naifeh; Lisa J Colpe; Pablo A Aliaga; Nancy A Sampson; Steven G Heeringa; Murray B Stein; Robert J Ursano; Carol S Fullerton; Matthew K Nock; Michael Schoenbaum; Alan M Zaslavsky; Ronald C Kessler
Journal:  Mil Med       Date:  2016-09       Impact factor: 1.437

10.  Risk Factors, Methods, and Timing of Suicide Attempts Among US Army Soldiers.

Authors:  Robert J Ursano; Ronald C Kessler; Murray B Stein; James A Naifeh; Pablo A Aliaga; Carol S Fullerton; Gary H Wynn; Patti L Vegella; Tsz Hin Hinz Ng; Bailey G Zhang; Christina L Wryter; Nancy A Sampson; Tzu-Cheg Kao; Lisa J Colpe; Michael Schoenbaum; James E McCarroll; Kenneth L Cox; Steven G Heeringa
Journal:  JAMA Psychiatry       Date:  2016-07-01       Impact factor: 21.596

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