Mental Health Care Utilization Following Return to Service After Rehabilitation in the Warrior Care and Transition Program

Introduction US service members have a high risk of injury, which can require long-term mental health care. The Warrior Care and Transition Program's (WCTP) mission is to rehabilitate seriously wounded soldiers. This study evaluates the effect of the WCTP on soldier's mental health after returning to the Force. Materials and Methods Warrior Care and Transition Program participants who returned to active duty between 2007 and 2017 were identified. The injury at entry into the WCTP was classified: physical injury (PhI), a mental health injury (MHI), or physical and mental health injury (Ph&MHI). Follow-up mental health care was identified. Poisson regression estimated the rate of mental health care visits in the 2 years after exit from the WCTP. This cohort of soldiers was matched to non-WCTP soldiers on demographic factors. Poisson Regression was used to estimate the rate of mental health care visits. ­Sub-outcomes of visits for alcohol and substance disorder care and sleep disorder care were also evaluated. Results Warrior Care and Transition Program participants with Ph&MHI and MHI had increased visit rates for outpatient care: rate ratio (RR): 3.04 (95% confidence interval [CI], 3.00-3.07) and RR: 3.24, (95% CI, 3.20-3.29), respectively. Inpatient mental health care visits were increased as well: Ph&MHI (RR 4.22, [95% CI, 3.86-4.60]) and MHI (RR 5.31, [95% CI, 4.83-5.84]). Warrior Care and Transition Program participants had increased rates of outpatient, RR 4.66, [95% CI, 4.35-4.99], and inpatient, RR 3.83, [95% CI, 3.32-4.40], mental health care visits compared with non-WCTP soldiers. Similar trends occurred for both sub-outcomes. Conclusions After returning to the Force from the WCTP, soldiers with Ph&MHI and MHI had increased rates of visits compared with soldiers with a PhI. Regardless of injury, after returning to the Force, WCTP participants had increased rates of visits compared to non-WCTP soldiers. Warrior Care and Transition Program participants, particularly those whose injury had a mental health component, will need further support during their military career.