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

Finn, Jacob A., PhD; Lamberty, Greg J., PhD; Tang, Xinyu, PhD; Saylors, Marie E., MPH; Stevens, Lillian Flores, PhD; Kretzmer, Tracy, PhD

The Journal of Head Trauma Rehabilitation: July/August 2018 - Volume 33 - Issue 4 - p E1–E9
doi: 10.1097/HTR.0000000000000357
Focus on Clinical Research and Practice

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.

Extended Care & Rehabilitation Service, Minneapolis VA Health Care System, Minneapolis, Minnesota (Dr Finn); Defense and Veteran Brain Injury Center (DVBIC), Minneapolis, Minnesota (Drs Finn and Lamberty); Department of Psychiatry, University of Minnesota–Twin Cities, Minneapolis (Dr Finn); Mental Health Service, Minneapolis VA Health Care System, Minneapolis, Minnesota (Dr Lamberty); Biostatistics Program, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock (Dr Tang and Ms Saylors); Mental Health Service, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia (Dr Stevens); Department of Psychology, Virginia Commonwealth University, Richmond (Dr Stevens); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond (Dr Stevens); Defense and Veterans Brain Injury Center (DVBIC), Richmond, Virginia (Dr Stevens); and MHBS, James A. Haley Veterans' Hospital, Tampa, Florida (Dr Kretzmer).

Corresponding Author: Jacob A. Finn, PhD, Minneapolis VA Health Care System, One Veterans Dr, Minneapolis, MN 55417 (

This research was sponsored by VHA Central Office VA TBI Model Systems Program of Research, Subcontract from General Dynamics Health Solutions (W91YTZ-13-C-0015) from the Defense and Veterans Brain Injury Center within the Defense Health Agency.

The authors acknowledge the support of US Department of Veterans Affairs Health Services Research and Development COIN grant (1 I50 HX001233-01; CINDRR) for assistance in manuscript preparation.

The authors declare no conflicts of interest.

The views, opinions, and/or findings contained in this article are those of the authors and should not be construed as an official Department of Defense position or any other federal agency, policy, or decision unless so designated by other official documentation.

Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.

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