Prevalence of Perceived Stress and Mental Health Indicators Among Reserve-Component and Active-Duty Military Personnel

摘要

Objectives. We examined stress levels and other indicators of mental health in reservists and active-duty military personnel by deployment status. Methods. We used data from the Department of Defense Health-Related Behaviors surveys, which collect comprehensive, population-based data for reserve and active-duty forces. Data were collected from 18?342 reservists and 16?146 active-duty personnel. Results. Overall, with adjustment for sociodemographic and service differences, reservists reported similar or less work and family stress, depression, and anxiety symptoms than did active-duty personnel. However, reservists who had been deployed reported higher rates of suicidal ideation and attempts than did active-duty personnel who had been deployed and higher rates of post-traumatic stress disorder symptomatology than did any active-duty personnel and reservists who had not been deployed. The highest rates of suicidal ideation and attempts were among reservists who had served in theaters other than Iraq and Afghanistan. Conclusions. Our results suggest that deployment has a greater impact on reservists than on active-duty members, thus highlighting the urgent need for services addressing reservists’ unique postdeployment mental health issues. Also, deployment to any theater, not only Iraq or Afghanistan, represents unique threats to all service members’ mental well-being. The US military reserve component, which includes both Reserve and National Guard personnel, provides trained units and qualified persons for active-duty service in time of war or national emergency. Reserve-component personnel may be called to active-duty status to supplement the active-duty component during such times. National Guard units also provide personnel in response to state emergencies. As of July 2008, the total strength of the US military reserve component was 1.1 million, with approximately 10% serving with the active-duty component. 1 Once activated, reserve-component service members proceed through the same deployment stages and processes as do active-duty forces. However, they face additional challenges associated with being “citizen Soldiers,” such as arranging extended leaves of absence with civilian employers, planning for reintegration upon their return, and making arrangements for their families. Furthermore, the uncertainty that often accompanies activation and deactivation and the organizational constraints, such as lack of equipment and training readiness, have been associated with their psychological well-being. 2 Milliken et al. 3 found, on the basis of Post-Deployment Health Assessment and Post-Deployment Health Re-Assessment interviews, that more than twice as many reserve-component as active-duty service members returning from Operation Iraqi Freedom (OIF) reported symptoms sufficient to require mental health treatment (42.4% vs 20.3%, respectively). Although important, their study was limited to a sample of recently returning service members who may not be representative of the broader active-duty and reserve-component populations and thus may not provide an accurate picture of the relative mental health needs between and within components of the total force. Therefore, a need exists for population-based data comparing the mental health needs of active-duty and reserve-component personnel. Drawing on 2 comprehensive surveys, we helped to fill this data gap by providing the first population-based assessment and comparison of reserve-component and active-duty mental health on the basis of selected indicators during the OIF and Operation Enduring Freedom (OEF) conflicts. This work augments existing research 2 by examining specific mental health issues encountered by reservists, as suggested by Milliken et al., 3 rather than a global but somewhat vague construct of psychological well-being.