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. 2015 Dec;105(12):2564-9.
doi: 10.2105/AJPH.2015.302836. Epub 2015 Oct 16.

Prevalence, Comorbidity, and Prognosis of Mental Health Among US Veterans

Ranak B Trivedi  1 , Edward P Post  1 , Haili Sun  1 , Andrew Pomerantz  1 , Andrew J Saxon  1 , John D Piette  1 , Charles Maynard  1 , Bruce Arnow  1 , Idamay Curtis  1 , Stephan D Fihn  1 , Karin Nelson  1
Affiliations

Prevalence, Comorbidity, and Prognosis of Mental Health Among US Veterans

Ranak B Trivedi et al. Am J Public Health. 2015 Dec.

Abstract

Objectives: We evaluated the association of mental illnesses with clinical outcomes among US veterans and evaluated the effects of Primary Care-Mental Health Integration (PCMHI).

Methods: A total of 4 461 208 veterans were seen in the Veterans Health Administration's patient-centered medical homes called Patient Aligned Care Teams (PACT) in 2010 and 2011, of whom 1 147 022 had at least 1 diagnosis of depression, posttraumatic stress disorder (PTSD), substance use disorder (SUD), anxiety disorder, or serious mental illness (SMI; i.e., schizophrenia or bipolar disorder). We estimated 1-year risk of emergency department (ED) visits, hospitalizations, and mortality by mental illness category and by PCMHI involvement.

Results: A quarter of all PACT patients reported 1 or more mental illnesses. Depression, SMI, and SUD were associated with increased risk of hospitalization or death. PTSD was associated with lower odds of ED visits and mortality. Having 1 or more contact with PCMHI was associated with better outcomes.

Conclusions: Mental illnesses are associated with poor outcomes, but integrating mental health treatment in primary care may be associated with lower risk of those outcomes.

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Figures

FIGURE 1—
FIGURE 1—
Comorbidity of 5 mental illnesses among US veterans: 2010–2011. Note. PTSD = posttraumatic stress disorder; SMI = serious mental illness; SUD = substance use disorder.
See this image and copyright information in PMC

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