Getting Beyond “Don’t Ask; Don’t Tell”: an Evaluation of US Veterans Administration Postdeployment Mental Health Screening of Veterans Returning From Iraq and Afghanistan

• DOI: 10.2105/ajph.2007.115519
• Publication Date: 2008-02-29T02:42:15Z
• Authors: Karen H. Seal; Daniel Bertenthal; Shira Maguen; Kristian Gima; Ann Chu; Charles R. Marmar
• Keywords: Veterans Affairs; Afghan; Depression; Attendance; Patient Health Questionnaire

We sought to evaluate outcomes of the Veterans Administration (VA) Afghan and Iraq Post-Deployment Screen for mental health symptoms.Veterans clinicians were encouraged refer or Afghanistan veterans who screened positive posttraumatic stress disorder, depression, high-risk alcohol use a VA clinic. Multivariate methods used determine predictors screening, proportions particular problems, clinic attendance.Among 750 referred medical center 5 associated community clinics, 338 underwent postdeployment screening; 233 (69%) problems. Having been seen in primary care (adjusted odd ratio [AOR]=13.3; 95% confidence interval [CI]=8.31, 21.3) at (AOR=3.28; CI=2.03, 5.28) predicted screening. African American less likely have than White (AOR=0.45; CI=0.22, 0.91). Of positive, 170 (73%) completed follow-up visit.A substantial proportion met screening criteria co-occurring suggesting that screens may help overcome "don't ask, don't tell" climate surrounds stigmatized illness. Based on data from 1 facility, increases attendance among veterans.