Comparison of national trends in mental health service use intensity in Canadian military and civilian populations

Abstract: Introduction: It is important to ensure that once military members access mental health services, they receive adequate care. Adequate care can be defined in many ways and typically includes a consideration of the number of visits, that is, mental health service use (MHSU) intensity. This study examined changes in the past decade in MHSU intensity in Canadian military members and comparable civilians. Methods: Data were drawn from four cross-sectional, nationally representative population health surveys that employed nearly identical methodology to examine and compare trends in MHSU adequacy/intensity in the Canadian military and comparable civilians between 2002 and 2012/13. Rate ratios (RR) were computed using negative binomial regression models, with adjustment for socio-demographic and clinical need variables. Results: The results indicated MHSU intensity increased in both military and comparable civilians over the past decade, but the increase reached statistical significance only in civilians. The relative increase was not statistically significantly different between the two populations. Discussion: The relative increase in MHSU intensity in both military and civilian populations is reassuring and consistent with gains in other aspects of MHSU. However, there is a need to examine adequacy of care using more sophisticated measures and to try to determine which programs or policies are responsible for the observed favorable changes in MHSU intensity.