Patterns and predictors of treatment delay for mental disorders in a nationally representative, active canadian military sample

Abstract

BACKGROUND: Although mental disorders constitute a significant public health problem in military populations, little is known about whether military members seek mental health treatment in a timely manner. OBJECTIVE:: The objective of this study was to examine delays in making the initial treatment contact for various mental disorders in a military population. DESIGN:: A cross-sectional analysis was conducted using data from the Canadian Community Health Survey-Canadian Forces Supplement. SUBJECTS AND MEASURES:: Participants (N = 8441) were assessed for mood and anxiety disorders, using the World Health Organization's Composite International Diagnostic Interview. Those meeting criteria for at least 1 disorder in their lifetime were included in the analyses. RESULTS:: The majority (82%-100%) of military members with a DSM-IV disorder eventually seek treatment. However, there are significant delays in seeking treatment. Median delays for major depressive disorder, generalized anxiety disorder, posttraumatic stress disorder, panic disorder, and social phobia are 3, 3, 7, 8, and 26 years, respectively. For deployment related posttraumatic stress disorder, longer delays are associated with being in an older age cohort, being male, not having comorbid panic disorder, and shorter military service duration. Across all disorders, longer delays are associated with being in an older age cohort, shorter military service duration, and earlier age of onset. CONCLUSIONS:: Failure to initiate treatment in a timely manner is a major mental health service access issue in the military context. Interventions that aim to shorten treatment delays are needed and should target military members most at risk for delaying treatment. Copyright © 2009 by Lippincott Williams & Wilkins.