Surveying Treatment Preferences in U.S. Iraq-Afghanistan Veterans With PTSD Symptoms: A Step Toward Veteran-Centered Care

This study examined health care barriers and preferences among a self‐selected sample of returning U.S. veterans drawn from a representative, randomly selected frame surveyed about posttraumatic stress disorder (PTSD) symptomatology and mental health utilization in the prior year. Comparisons between treated (n = 160) and untreated (n = 119) veterans reporting PTSD symptoms were conducted for measures of barriers and preferences, along with logistic models regressing mental health utilization on clusters derived from these measures. Reported barriers corroborated prior research findings as negative beliefs about treatment and stigma were strongly endorsed, but only privacy concerns were associated with lower service utilization (B = −0.408, SE = 0.142; p = .004). The most endorsed preference (91.0%) was for assistance with benefits, trailed by help for physical problems, and particular PTSD symptoms. Help‐seeking veterans reported stronger preferences for multiple interventions, and desire for services for families (B = 0.468, SE = 0.219; p = .033) and specific PTSD symptoms (B = 0.659, SE = 0.302; p = .029) were associated with increased utilization. Outcomes of the study suggested PTSD severity drove help‐seeking in this cohort. Results also support the integration of medical and mental health services, as well as coordination of health and benefits services. Finally, the study suggested that outreach about privacy protections and treatment options could well improve engagement in treatment. Resumen Preferencias de tratamiento en los veteranos de OEF‐OIF Este estudio examinó las barreras y preferencias de atención sanitaria en una muestra auto‐seleccionada de veteranos retornados a partir de una encuesta representativa, randomizada sobre la sintomatología de TEPT y el uso de tratamiento de salud mental en el año previo. Las comparaciones entre veteranos tratados (n = 160) y no tratados (n = 119) que reportaron síntomas TEPT se llevaron a cabo mediante mediciones de barreras y preferencias, con un modelo de regresión logística del uso de tratamiento en salud mental en grupos derivados de estas mediciones. Las barreras reportadas corroboran hallazgos previos, como creencias negativas acerca del tratamiento y el estigma, que fueron fuertemente respaldados, pero sólo las preocupaciones acerca de la privacidad estuvieron asociadas con el bajo uso de los servicios (β = −0.408, SE = 0.142; p = .004). La preferencia más avalada (>93.0%) fue por la asistencia con