Michelle A Mengeling1, Brenda M Booth, James C Torner, Anne G Sadler. 1. *The Center for Comprehensive Access & Delivery Research and Evaluation (CADRE) †VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Central Region (VRHRC-CR), Iowa City VA Health Care System ‡Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA §Center for Mental Healthcare Outcomes and Research, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas; Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR ∥Department of Epidemiology, University of Iowa College of Public Health Departments of ¶Neurosurgery #Surgery **Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA.
Abstract
BACKGROUND AND OBJECTIVES: Few who experience sexual assault seek health care immediately. Yet many become heavy users of health care resources in the years postassault because sexual violence has been linked with both acute and chronic health consequences. Our objective was to investigate servicewomen's medical and mental health (MH) care utilization after sexual assault in-military (SAIM) and identify reasons for not seeking care. METHODS: In a retrospective cross-sectional Midwestern community sample of OEF/OIF Active Component and Reserve/National Guard servicewomen, currently serving and veterans, computer-assisted telephone interviews were conducted with 207 servicewomen who experienced SAIM. RESULTS: A quarter (25%) received post-SAIM MH care and 16% medical care. Utilization of medical care tended to be sooner (within the first month) and MH care later (6 mo to 1+ y). Most sought care on a military base, a third from civilian providers, and 10% sought MH from Veterans Health Administration. Servicewomen were more likely to have utilized medical care if they had experienced a completed SAIM and made a Department of Defense SAIM report and MH care if they were white, experienced on-duty SAIM, and made a Department of Defense SAIM report. The most common reason for not seeking medical care was due to belief that care was not needed. Reasons for not utilizing medical or MH care included embarrassment, confidentiality concerns, and fear of adverse career consequences. CONCLUSIONS: Few servicewomen utilized post-SAIM care, thus assault-specific health consequences were likely unaddressed. Given the severe and chronic consequences of sexual assault, our findings emphasize need for military, Veterans Health Administration, and civilian providers to query SAIM history to provide timely and optimal care.
BACKGROUND AND OBJECTIVES: Few who experience sexual assault seek health care immediately. Yet many become heavy users of health care resources in the years postassault because sexual violence has been linked with both acute and chronic health consequences. Our objective was to investigate servicewomen's medical and mental health (MH) care utilization after sexual assault in-military (SAIM) and identify reasons for not seeking care. METHODS: In a retrospective cross-sectional Midwestern community sample of OEF/OIF Active Component and Reserve/National Guard servicewomen, currently serving and veterans, computer-assisted telephone interviews were conducted with 207 servicewomen who experienced SAIM. RESULTS: A quarter (25%) received post-SAIM MH care and 16% medical care. Utilization of medical care tended to be sooner (within the first month) and MH care later (6 mo to 1+ y). Most sought care on a military base, a third from civilian providers, and 10% sought MH from Veterans Health Administration. Servicewomen were more likely to have utilized medical care if they had experienced a completed SAIM and made a Department of Defense SAIM report and MH care if they were white, experienced on-duty SAIM, and made a Department of Defense SAIM report. The most common reason for not seeking medical care was due to belief that care was not needed. Reasons for not utilizing medical or MH care included embarrassment, confidentiality concerns, and fear of adverse career consequences. CONCLUSIONS: Few servicewomen utilized post-SAIM care, thus assault-specific health consequences were likely unaddressed. Given the severe and chronic consequences of sexual assault, our findings emphasize need for military, Veterans Health Administration, and civilian providers to query SAIM history to provide timely and optimal care.
Authors: Nicole A Short; Megan Lechner; Benjamin S McLean; Andrew S Tungate; Jenny Black; Jennie A Buchanan; Rhiannon Reese; Jeffrey D Ho; Gordon D Reed; Melissa A Platt; Ralph J Riviello; Catherine H Rossi; Patricia P Nouhan; Carolyn A Phillips; Sandra L Martin; Israel Liberzon; Sheila A M Rauch; Kenneth A Bollen; Ronald C Kessler; Samuel A McLean Journal: Depress Anxiety Date: 2020-10-08 Impact factor: 6.505