Behavioral Health and Service Use Among Civilian Wives of Service Members and Veterans

Evidence from the National Survey of Drug Use and Health

by Joshua Breslau, Ryan Andrew Brown

Download Free Electronic Document

FormatFile SizeNotes
PDF file 0.2 MB

Use Adobe Acrobat Reader version 10 or higher for the best experience.

Research Questions

  1. Who are the wives covered by TRICARE or CHAMP-VA?
  2. Do military wives differ from a comparison sample with respect to behavioral health status?
  3. Do military wives differ from the comparison group with respect to use of behavioral health services?
  4. Does use of behavioral health services differ by urbanicity?
  5. Is proximity to an MTF associated with use of behavioral health services among military wives?

In recent years, policymakers and members of the media have raised concerns regarding access to behavioral health care for service members and veterans of the U.S. military and their families. Particular concern has been raised regarding the availability and accessibility of care to individuals covered by the U.S. Department of Defense Military Health System and the Veterans Health Administration. In this report, researchers analyzed the National Study of Drug Use and Health to examine utilization of behavioral health care among current or former wives of service members and veterans who are covered by either TRICARE or CHAMP-VA. Three findings of interest emerged from the analysis. First, relative to the comparison group, military wives were more likely to receive behavioral health services, but this pattern was exclusively due to use of prescription psychiatric medications. No difference was found for specialty behavioral health treatment. Second, residing in rural areas was negatively associated with behavioral health care service use for both groups. Third, contrary to expectations, military wives who live more than 30 minutes from a military treatment facility were more likely than military wives who lived closer to receive prescription psychiatric mediations but not other types of behavioral health services.

Key Findings

Behavioral Health Status of the Two Groups Was Similar

  • The military wives and the comparison sample were fairly similar in past-year behavioral health status. However, there is evidence that military wives are more likely to have had major depression in their lifetimes.

Behavioral Health Services Use Was Similar Between the Two Groups

  • The military wives were more likely to have received behavioral health service in the past year, but this difference was not consistent across the types of services. The difference was entirely due to higher use of prescription psychiatric medications among military wives.

Place of Residence Played a Minor Role in Use of Services

  • Military wives in more rural areas are less likely to use any type of behavioral health services, significantly so for substance use disorder treatment. The likelihood of receiving specialty behavioral health treatment is similar in metropolitan noncore and metropolitan core areas, but lower among residents of micropolitan and small towns and rural areas.
  • One surprising finding was that proximity to an MTF and use of behavioral health services differed significantly between military wives and the comparison group. Military wives living close to an MTF showed lower use of behavioral health services than those living farther away. For the comparison group, proximity to an MTF is associated with higher likelihood of using services.
  • However, military wives who live near an MTF are less likely to use prescription medication than those who live farther away. Comparing the military wives to the comparison group suggests that the latter group, the military wives who are not near an MTF, are the true exceptions, with higher use of prescription medication treatment for mental health conditions than all other groups.

Recommendation

  • Examine patterns of access to care among military dependents living near MTFs (as well as remote from MTFs) in greater detail to further understand disparities in access to care.

This research was conducted within the Forces and Resources Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by the Office of the Secretary of Defense, the Joint Staff, the Unified Combatant Commands, the Navy, the Marine Corps, the defense agencies, and the defense Intelligence Community.

This report is part of the RAND Corporation research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.