“A Hidden Community”: The Experiences of Help-Seeking and Receiving Mental Health Treatment in U.K. Women Veterans. A Qualitative Study
Abstract: Women veterans are often underserved in both the research into and provision of mental health treatment. This study explored women veterans’ experiences of mental health difficulties, help-seeking, and treatment provision. Semistructured telephone interviews with 19 U.K. women veterans who met criteria for posttraumatic stress disorder were conducted and Reflexive Thematic Analysis was used in analysis. Three superordinate themes encompassing participants’ experiences were developed: (a) attitudes toward mental health and help-seeking; (b) the need to acknowledge the uniqueness of women veterans; and (c) the structural elements of care provision. The findings indicate that women veterans have additional gender-specific challenges and needs concerning tailored pathways into help and support, as well as the environment and modality of treatment delivery, as distinct from veteran men.
Abstract: Objectives: Increasing numbers of older adults are reentering community following incarceration (i.e., reentry), yet risk of incident neurodegenerative disorders associated with reentry is unknown. Our objective was to determine association between reentry status (reentry vs never-incarcerated) and mild cognitive impairment (MCI) and/or dementia. Methods: This nationwide, longitudinal cohort study used linked Centers for Medicare & Medicaid Services and Veterans Health Administration data. Participants were aged 65 years or older who experienced reentry between October 1, 2012, and December 31, 2018, with no preincarceration MCI/dementia, compared with age-matched/sex-matched never-incarcerated veterans. MCI/dementia was defined by diagnostic codes. Fine-Gray proportional hazards models were used to examine association. Results: This study included 35,520 veterans, mean age of 70 years, and approximately 1% women. The reentry group (N = 5,920) had higher incidence of MCI/dementia compared with the never-incarcerated group (N = 29,600; 10.2% vs 7.2%; fully adjusted hazard ratio [aHR] 1.12; 95% CI 1.00-1.25). On further investigation, reentry was associated with increased risk of dementia with or without prior MCI diagnosis (aHR 1.21; 95% CI 1.06-1.39) but not MCI only. Discussion: Transition from incarceration to community increased risk of neurocognitive diagnosis. Findings indicate health/social services to identify and address significant cognitive deficits on late-life reentry. Limitations include generalizability to nonveterans.