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Résumé (français)

Recent research shows an increase in the mental health needs of Canadian Armed Forces (CAF) personnel (Fikretoglu, Liu, Zamorski, & Jetly, 2016). Research also indicates that a portion of CAF personnel with a mental health need do not seek professional mental health care or fail to initiate treatment in a timely fashion (e.g., Fikretoglu, Liu, Pedlar, & Brunet, 2010; Zamorski & Boulos, 2014). Andersen’s (1995; 2008) Behavioral Model of Health Services Use suggests predisposing factors (e.g., age), enabling/impeding factors (e.g., income), and need-related factors (e.g., mental health diagnosis) can help explain professional mental health care seeking behaviors. Several studies conducted with military samples have investigated factors that can impede the care seeking process (i.e., barriers; e.g., Sareen, Cox, et al., 2007); however, relatively less is known about factors that may facilitate access to mental health care. The current studies explored recent patterns of professional and paraprofessional mental health service use in CAF personnel. The studies were designed to identify different means by which access to mental health care may be increased in this population. Specifically, Study 1 assessed the propensity of CAF personnel to seek help from their social network (e.g., family, coworkers), as well as the impact of seeking such help on professional mental health service use and perceived need for care. Study 2 examined individual predictors of using a paraprofessional peer support program available to CAF personnel, veterans, and their families (i.e., Operational Stress Injury Social Support [OSISS]). Study 3 identified the frequency of Internet use for mental health related activities among CAF personnel and individual predictors of use. Participants in all three studies included Regular Members from a recent nationally representative Canadian military sample (n ~ 6,700; Canadian Forces Mental Health Survey; Statistics Canada, 2014). ii Weighting and bootstrapping estimation procedures were used to account for the complex survey design. Prevalence estimates were computed for all three studies and multivariate logistic regression analyses served to identify predictors of professional mental health service use, perceived need for care, OSISS use, and Internet use for mental health related activities. The results indicate that: 1) seeking support from various social groups is positively related to professional mental health service use and perceived need for care; 2) meeting criteria for posttraumatic stress disorder has the strongest association with OSISS use, but only a small number of CAF personnel seek help from OSISS; and 3) the Internet is more readily accessed than other forms of paraprofessional mental health care (e.g., OSISS) and few individual barriers exist to Internet use for mental health related activities among CAF personnel. The results suggest that developing psychoeducational programs and resources readily available to the social networks of military personnel (e.g., family members) may help facilitate access to professional mental health care. The results also suggest mental health resources may be best delivered to military personnel and their social networks through in-person professional mental health services or Internet-based technologies. Comprehensive results, methodological considerations, implications, and future research are discussed.

Résumé (anglais)

Recent research shows an increase in the mental health needs of Canadian Armed Forces (CAF) personnel (Fikretoglu, Liu, Zamorski, & Jetly, 2016). Research also indicates that a portion of CAF personnel with a mental health need do not seek professional mental health care or fail to initiate treatment in a timely fashion (e.g., Fikretoglu, Liu, Pedlar, & Brunet, 2010; Zamorski & Boulos, 2014). Andersen’s (1995; 2008) Behavioral Model of Health Services Use suggests predisposing factors (e.g., age), enabling/impeding factors (e.g., income), and need-related factors (e.g., mental health diagnosis) can help explain professional mental health care seeking behaviors. Several studies conducted with military samples have investigated factors that can impede the care seeking process (i.e., barriers; e.g., Sareen, Cox, et al., 2007); however, relatively less is known about factors that may facilitate access to mental health care. The current studies explored recent patterns of professional and paraprofessional mental health service use in CAF personnel. The studies were designed to identify different means by which access to mental health care may be increased in this population. Specifically, Study 1 assessed the propensity of CAF personnel to seek help from their social network (e.g., family, coworkers), as well as the impact of seeking such help on professional mental health service use and perceived need for care. Study 2 examined individual predictors of using a paraprofessional peer support program available to CAF personnel, veterans, and their families (i.e., Operational Stress Injury Social Support [OSISS]). Study 3 identified the frequency of Internet use for mental health related activities among CAF personnel and individual predictors of use. Participants in all three studies included Regular Members from a recent nationally representative Canadian military sample (n ~ 6,700; Canadian Forces Mental Health Survey; Statistics Canada, 2014). ii Weighting and bootstrapping estimation procedures were used to account for the complex survey design. Prevalence estimates were computed for all three studies and multivariate logistic regression analyses served to identify predictors of professional mental health service use, perceived need for care, OSISS use, and Internet use for mental health related activities. The results indicate that: 1) seeking support from various social groups is positively related to professional mental health service use and perceived need for care; 2) meeting criteria for posttraumatic stress disorder has the strongest association with OSISS use, but only a small number of CAF personnel seek help from OSISS; and 3) the Internet is more readily accessed than other forms of paraprofessional mental health care (e.g., OSISS) and few individual barriers exist to Internet use for mental health related activities among CAF personnel. The results suggest that developing psychoeducational programs and resources readily available to the social networks of military personnel (e.g., family members) may help facilitate access to professional mental health care. The results also suggest mental health resources may be best delivered to military personnel and their social networks through in-person professional mental health services or Internet-based technologies. Comprehensive results, methodological considerations, implications, and future research are discussed.