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NEW YORK (Reuters Health) - Mental health assessments given to all soldiers after deployment may miss many cases of depression and post-traumatic stress disorder, suggests a new study.
When returning soldiers took the screening tests anonymously -- instead of identifying themselves, as is the norm -- they were between twice and four times as likely to report mental health problems and to say they needed help, the study found.
That could be because the stigma associated with having mental health problems in the military initially kept them quiet, researchers wrote in the Archives of General Psychiatry on Monday.
"There is concern about the impact of seeking help on their career and on how others will perceive them," said Lieutenant Colonel Christopher Warner, one of the study's authors from U.S. Army Medical Activity - Alaska, at Fort Wainwright.
The study "tells us that we need to continue to work and to seek different mechanisms that will encourage soldiers to get help and understand that (getting treatment) is a strength, not a weakness."
His team's research involved about 3,500 soldiers who were in Iraq in 2007 to 2008 for their third deployment in six years. Before soldiers returned to Fort Stewart, Georgia, they completed the standard, computer-based post-deployment health assessment, which includes questions on PTSD and other mental health problems.
That assessment is not anonymous, and is meant to spot problems and help connect soldiers with care when they get home.
About half of the soldiers also completed an anonymous paper questionnaire with the same mental health screening questions.
Just over four percent of the returning troops met the criteria for depression or PTSD based on their standard health assessments. When they did the survey anonymously, 12 percent screened positive for at least one of the conditions.
Soldiers were also four times more likely to say they had thoughts of suicide on anonymous assessments.
Warner and his colleagues say that the findings don't show the normal post-deployment screening doesn't work, but that additional strategies are needed to encourage returning soldiers to get the mental health care they need.
Some might not report depression or PTSD because they aren't confident that good services will be available to help them anyway, the researchers add.
Warner said that in the past few years, the military has stepped up its efforts to make mental health services available in a range of settings, from primary care offices to over the phone.
"What we don't want to happen, is a soldier who asked for help once, and for any reason doesn't follow through with their care," he told Reuters Health.
But, he added, the current study shows that more work is needed to continue to expand those opportunities for soldiers to get care for mental health problems and to reverse the stigma associated with that care.
SOURCE: bit.ly/o74mDG Archives of General Psychiatry, online October 3, 2011.