4.6 Article

Retrospective Examination of Service Dog Training Program Participation and Mental Healthcare Utilization

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W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.apmr.2022.07.009

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Animal assisted therapy; Anxiety disorders; Military health; Mood disorders; Patient acceptance of health care; Psychotropic drugs; Rehabilitation; Service animals; Sleep disorders; circadian rhythm; Stress disorders; post-traumatic

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The objective of this study is to investigate the association between participation in the Service Dog Training Program (SDTP) and mental health care utilization. The results suggest that participants who attended more than 2 SDTP sessions per month had different mental health care utilization post SDTP compared to those who attended 1 or fewer sessions per month. Therefore, adjunct therapies such as the SDTP may offer patients a nonstigmatizing way to engage in mental health care.
Objective: To investigate the association between Service Dog Training Program (SDTP) participation and mental health care utilization. Setting: Outpatient rehabilitation clinic at a large military treatment facility. Participants: Military Health System beneficiaries who attended at least 1 SDTP session at a large military treatment facility (N=597). SDTP program enrollment records identified participants. Intervention: The SDTP, a unique application of animal-assisted therapy, is intended to improve the mental and cognitive health for individuals with war-related trauma. Main Outcome Measures: Negative binomial regression calculated the associations between the SDTP participation rate and 2 mental health care utilization outcomes: mental health encounter days and psychotropic medication months' supply. Results: Most of the 597 participants were male, enlisted service members, and aged 25-34 years. Approximately 46% had a posttraumatic stress disorder diagnosis, 21% had a traumatic brain injury diagnosis, 47% had an opioid prescription, and 58% had a sleep aid prescription pre-SDTP participation. Participation was categorized into low (<= 1 sessions), medium (>1 and <= 2 sessions), and high (>2 sessions) monthly participation. In adjusted analysis, high monthly SDTP participation was associated with 18% fewer post-SDTP mental health encounter days (rate ratio [RR], 0.82; 95% confidence interval [CI], 0.68-0.96) than low monthly SDTP participation. High monthly SDTP participation was also associated with a 22% fewer post-SDTP psychotropic prescription months' supply (RR, 0.78; 95% CI, 0.64-0.95) than low monthly SDTP participation in adjusted analysis. Conclusions: Results suggest that participants who attend more than 2 SDTP sessions monthly encounter mental health care differently post SDTP than participants who attended 1 or fewer monthly sessions. Adjunct therapies, such as the SDTP, may offer patients a nonstigmatizing way to engage in mental health care. Archives of Physical Medicine and Rehabilitation 2023;104:237-44

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