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

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.