For some soldiers with posttraumatic stress disorder (PTSD), the stress of readjusting to civilian life after combat is a stronger motivator of treatment seeking than their symptoms of PTSD. Research presented in the September issue of Psychiatric Services, a journal of the American Psychiatric Association, found that for older soldiers with family and occupational responsibilities, readjustment stressors related to marriage, financial, or family issues upon return from deployment were associated with seeking help for PTSD.

Many veterans who need mental health care do not receive it, and while much research has focused on treatment barriers, researcher Alejandro Interian, Ph.D., and colleagues sought to identify factors that motivate or characterize veterans who do seek care.

Interian and colleagues surveyed a sample of National Guard soldiers with PTSD three months after they returned from Iraq. Nearly three-quarters (72%) reported experiencing readjustment stressors. Among older soldiers who had family and occupational responsibilities, these stressors were strong motivators to seek PTSD treatment, even stronger than their symptoms of PTSD and depression.

Among the returning soldiers with PTSD, 34% had made a mental health visit during the three-month post-deployment period and 23% had been prescribed psychotropic medication. Although this means that some two-thirds of these returning veterans with PTSD did not seek treatment, this rate of treatment seeking is higher than that for the U.S. population overall—an estimated 7% of the U.S. population with PTSD seeks care within the first year of onset.

The authors conclude that because rates of treatment seeking in their sample were at least partially accounted for by demographic variables and the role of greater familial and occupational responsibilities, "treatment seeking may be motivated by social encouragement or social interference and less by symptom severity."

Two other studies reported in the September issue of Psychiatric Services also address service members' use of mental health care. A study by Elizabeth Brooks, Ph.D., and colleagues found that service use by veterans is lower in rural areas than urban areas and that veterans from Iraq and Afghanistan use less care than those from earlier conflicts. Researchers led by Kristin Naragon-Gainey, Ph.D., looked at the association of distress symptoms (e.g., pain, depression, PTSD, and panic disorder) and high-risk behaviors (e.g., alcohol use and aggression) with treatment seeking in various settings. They found that veterans may overutilize emergency care and underutilize specialty mental health services.