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Importance of anonymity to encourage honest reporting in mental health screening after combat deployment.
Arch Gen Psychiatry. 2011 Oct; 68(10):1065-71.AG

Abstract

CONTEXT

US soldiers are required to undergo screening for depression, posttraumatic stress disorder (PTSD), and other mental health problems on return from service in Iraq or Afghanistan as part of routine postdeployment health assessments.

OBJECTIVE

To assess the influence of the anonymity of screening processes on willingness of soldiers to report mental health problems after combat deployment.

DESIGN

Anonymous and nonanonymous surveys.

SETTING

US military.

PATIENTS

US infantry soldiers' reporting of mental health problems on the routine Post-Deployment Health Assessment was compared with their reporting on an anonymous survey administered simultaneously.

MAIN OUTCOME MEASURES

The Primary Care PTSD Screen, the Patient Health Questionnaire-2 (modified), the suicidal ideation question from the Patient Health Questionnaire-9, and several other questions related to mental health were used on both surveys. Soldiers were also asked on the anonymous survey about perceptions of stigma and willingness to report honestly.

RESULTS

Of 3502 US Army soldiers from one infantry brigade combat team undergoing the routine Post-Deployment Health Assessment in 2008, a total of 2500 were invited to complete the anonymous survey, and 1712 of these participated (response rate, 68.5%). Reporting of depression, PTSD, suicidal ideation, and interest in receiving care were 2-fold to 4-fold higher on the anonymous survey compared with the routine Post-Deployment Health Assessment. Overall, 20.3% of soldiers who screened positive for depression or PTSD reported that they were uncomfortable reporting their answers honestly on the routine postdeployment screening.

CONCLUSIONS

Current postdeployment mental health screening tools are dependent on soldiers honestly reporting their symptoms. This study indicates that the Post-Deployment Health Assessment screening process misses most soldiers with significant mental health problems. Further efforts are required to reduce the stigma of reporting and improve willingness to receive care for mental health problems.

Authors+Show Affiliations

Command and General Staff College, Ft Leavenworth, Kansas, USA. Christopher.H.Warner@us.army.milNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21969463

Citation

Warner, Christopher H., et al. "Importance of Anonymity to Encourage Honest Reporting in Mental Health Screening After Combat Deployment." Archives of General Psychiatry, vol. 68, no. 10, 2011, pp. 1065-71.
Warner CH, Appenzeller GN, Grieger T, et al. Importance of anonymity to encourage honest reporting in mental health screening after combat deployment. Arch Gen Psychiatry. 2011;68(10):1065-71.
Warner, C. H., Appenzeller, G. N., Grieger, T., Belenkiy, S., Breitbach, J., Parker, J., Warner, C. M., & Hoge, C. (2011). Importance of anonymity to encourage honest reporting in mental health screening after combat deployment. Archives of General Psychiatry, 68(10), 1065-71. https://doi.org/10.1001/archgenpsychiatry.2011.112
Warner CH, et al. Importance of Anonymity to Encourage Honest Reporting in Mental Health Screening After Combat Deployment. Arch Gen Psychiatry. 2011;68(10):1065-71. PubMed PMID: 21969463.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Importance of anonymity to encourage honest reporting in mental health screening after combat deployment. AU - Warner,Christopher H, AU - Appenzeller,George N, AU - Grieger,Thomas, AU - Belenkiy,Slava, AU - Breitbach,Jill, AU - Parker,Jessica, AU - Warner,Carolynn M, AU - Hoge,Charles, PY - 2011/10/5/entrez PY - 2011/10/5/pubmed PY - 2011/12/13/medline SP - 1065 EP - 71 JF - Archives of general psychiatry JO - Arch Gen Psychiatry VL - 68 IS - 10 N2 - CONTEXT: US soldiers are required to undergo screening for depression, posttraumatic stress disorder (PTSD), and other mental health problems on return from service in Iraq or Afghanistan as part of routine postdeployment health assessments. OBJECTIVE: To assess the influence of the anonymity of screening processes on willingness of soldiers to report mental health problems after combat deployment. DESIGN: Anonymous and nonanonymous surveys. SETTING: US military. PATIENTS: US infantry soldiers' reporting of mental health problems on the routine Post-Deployment Health Assessment was compared with their reporting on an anonymous survey administered simultaneously. MAIN OUTCOME MEASURES: The Primary Care PTSD Screen, the Patient Health Questionnaire-2 (modified), the suicidal ideation question from the Patient Health Questionnaire-9, and several other questions related to mental health were used on both surveys. Soldiers were also asked on the anonymous survey about perceptions of stigma and willingness to report honestly. RESULTS: Of 3502 US Army soldiers from one infantry brigade combat team undergoing the routine Post-Deployment Health Assessment in 2008, a total of 2500 were invited to complete the anonymous survey, and 1712 of these participated (response rate, 68.5%). Reporting of depression, PTSD, suicidal ideation, and interest in receiving care were 2-fold to 4-fold higher on the anonymous survey compared with the routine Post-Deployment Health Assessment. Overall, 20.3% of soldiers who screened positive for depression or PTSD reported that they were uncomfortable reporting their answers honestly on the routine postdeployment screening. CONCLUSIONS: Current postdeployment mental health screening tools are dependent on soldiers honestly reporting their symptoms. This study indicates that the Post-Deployment Health Assessment screening process misses most soldiers with significant mental health problems. Further efforts are required to reduce the stigma of reporting and improve willingness to receive care for mental health problems. SN - 1538-3636 UR - https://www.unboundmedicine.com/medline/citation/21969463/Importance_of_anonymity_to_encourage_honest_reporting_in_mental_health_screening_after_combat_deployment_ L2 - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/10.1001/archgenpsychiatry.2011.112 DB - PRIME DP - Unbound Medicine ER -