Twelve month use of mental health services in a nationally representative, active military sample

Background: Mental disorders constitute a significant public health problem in active military populations. However, very little is known about patterns of mental health service use in these populations. Objectives: The primary objective of this study was to examine the patterns and predictors of mental health service use in active Canadian Force members. Additional objectives included identification of barriers to service use. Design: A cross-sectional analysis was conducted using data from the Canadian Community Health Survey-Canadian Forces Supplement. Subjects and Measures: Participants were assessed for mood, anxiety, and substance use disorders using the World Health Organization's Composite International Diagnostic Interview. Those who met criteria for at least 1 disorder in the past year (n = 1220) were included in the analyses. Results: Of military members with a 12-month diagnosis, 42.6% used services in the past year. Predictors of service use included mental health indicators, gender, marital status, and military rank. Of military members who failed to use services, only a small percentage (3.5-16.0%) acknowledged a need for services. These members perceived a number of barriers to services, foremost among which was lack of trust in military health, administrative, and social services. Conclusions: Despite recent efforts to de-stigmatize mental health problems and treatments, unmet need for mental health services remains a significant problem in active militaries. Our findings indicate that military institutions should continue public education campaigns to de-stigmatize mental health problems and should make necessary changes in health delivery systems to gain the trust of military members.