Mental Health Care Utilization among Active Duty Service Members

ABOUT THIS REPORT

The following report provides an overview of mental health care utilization trends within the active duty service member (ADSM) population, including Guard and Reserves, of the United States military between fiscal years 2005 and 2015. The report contains statistics for the direct care component of the Military Health System (MHS), including the total, mean and median number of mental health-related outpatient visits, inpatient stays and inpatient bed days. These metrics are further stratified by the military service (Army, Air Force, Marines or Navy).

METHODOLOGY

All data was derived from the Military Health System Data Repository (MDR). This application provides access to all direct care inpatient and outpatient records for fiscal years 2005 through 2015 (Oct. 1, 2005 – Sep. 30, 2015).  All data was queried from the MDR application on April 8, 2016.

FINDINGS

  • The total number of direct care mental health-related outpatient visits among ADSMs increased by 263 percent from fiscal year 2005 (935,608) through fiscal year 2012 (2,460,552) and subsequently decreased through fiscal year 2015 (2,288,219). The mean number of mental health-related outpatient visits among ADSMs with at least one mental health-related outpatient visit steadily rose from fiscal year 2005 (5.07) through fiscal year 2015 (8.14). However, the median number of mental health-related outpatient visits only increased slightly, from 2 in fiscal year 2005 to 3 in fiscal year 2015. The discrepancy between mean and median suggests a small subset of ADSMs utilize a disproportionately high number of mental health-related outpatient services compared to the remainder of the ADSM population seeking mental health care.
  • The Army had the highest total number of direct care outpatient visits compared to the rest of the listed services, rising from 454,114 visits in fiscal year 2005 (49 percent of all visits in fiscal year 2005) to 1,466,007 in fiscal year 2012 (60 percent of all visits in fiscal year 2012) and decreasing slightly in the remaining three years of the measurement period.  This trend aligns with Army’s large ADSM population and high prevalence of mental health disorder diagnoses.

    See the PH by the Numbers report: "Mental Health Disorder Prevalence among Active Duty Service Members" for more details.

    However, the mean and median number of mental health-related outpatient visits among ADSMs with at least one mental health-related outpatient visit was only slightly higher among Army ADSMs compared to the remainder of the listed services during the measurement period.
  • The total number of direct care mental health-related inpatient stays rose from 8,958 in fiscal year 2005 to 12,663 in fiscal year 2011, declining to 11,816 in fiscal year 2015.  Consistent with reported trends in outpatient visits, the total number of mental health-related inpatient stays was highest among Army ADSMs, while the mean and median number of inpatient stays remained relatively similar between the Army and other services.
  • The total number of direct care inpatient mental health-related bed days rose from 51,510 in fiscal year 2005 to its highest level of 74,073 in fiscal year 2014. The average number of bed days among ADSMs remained fairly stable throughout fiscal years 2005 to 2015, hovering around 7. Consistent with reported trends in outpatient encounters and inpatient stays, the total number of mental health-related inpatient bed days was highest among Army ADSMs, whereas the mean and median number of inpatient bed days fluctuated among all listed services during the measurement period.