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Social Factors Predict Treatment Engagement in Veterans with PTSD or SUD

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Abstract

Veterans with PTSD and SUDs often fail to initiate, or prematurely discontinue, mental health treatment in Veteran Affairs Medical Centers (VAMC). While much is known about clinical characteristics and demographic factors impacting treatment engagement in this population, less is known about the role of social factors. This retrospective study examines primary care–based screening assessment and specialty mental healthcare appointment data in a VAMC, to test whether social factors predict treatment initiation and appointment attendance. Findings reveal veterans were more likely to initiate treatment when (a) those with SUDs (n = 235) reported more frequent negative exchanges with others and (b) those with PTSD (n = 2107) reported more perceived support or being partnered. Those with PTSD who were partnered had higher appointment attendance rates. Findings suggest social factors are relevant to treatment initiation among veterans with PTSD and SUDs and that close others may be helpful in facilitating referrals.

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Acknowledgements

This study was conducted at the Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Philadelphia, PA, 19104. We thank the VISN 4 Mental Illness Research, Education and Clinical Center for the research resources provided to us to complete this study. We thank Kevin Lynch for providing statistical expertise and consultation. We thank Ronald Ehrman and Shirley Chen for assistance with data extraction. These findings do not necessarily reflect the opinions or policies of VA or the Corporal Michael J. Crescenz VA Medical Center, Philadelphia.

Funding

The writing of this manuscript was supported by the Office of Academic Affiliations, Advanced Fellowship Program in Mental Illness Research and Treatment, Department of Veterans Affairs. Data used in this research study was collected with financial support from VA HSRD IIR 19-031 to E. Kuhn & S. Sayers.

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Authors and Affiliations

  1. The Family Institute at Northwestern University, 618 Library Place, Evanston, IL, 60201, USA

    Hayley C. Fivecoat PhD

  2. Department of Psychology, Northwestern University, Evanston, IL, USA

    Hayley C. Fivecoat PhD

  3. Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA

    Hayley C. Fivecoat PhD, Shahrzad Mavandadi PhD, James R. McKay PhD & Steven L. Sayers PhD

  4. Irvine Medical Center, Columbia University, New York, NY, USA

    Samantha J. Lookatch PhD

  5. Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA

    Shahrzad Mavandadi PhD, James R. McKay PhD & Steven L. Sayers PhD

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Fivecoat, H.C., Lookatch, S.J., Mavandadi, S. et al. Social Factors Predict Treatment Engagement in Veterans with PTSD or SUD. J Behav Health Serv Res 50, 286–300 (2023). https://doi.org/10.1007/s11414-022-09823-2

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