Psychological distress in active-duty U.S. service members who utilized mental health services: Data from a 2018 DoD survey

Background: Military personnel face unique stressors to their mental health. Objectives: To estimate the prevalence of serious psychological distress among active-duty U.S. service members who utilized mental health services, and to identify related risk factors. Methods: We applied a cross-sectional secondary data analysis design utilizing the 2018 DoD Health Related Behaviors Survey. The primary outcome was serious psychological distress during the past 12 months as measured by the Kessler 6-item Psychological Distress Scale. Results: The weighted prevalence of past-year serious psychological distress among service members utilizing mental health services was 39.1 % (95 % CI: 36.7–41.6 %). Significantly increased odds of serious psychological distress were seen among those who were separated, widowed, or divorced, and those in the Army, Navy, or Marine Corps. Decreased odds were seen for those in higher paygrades and those with at least a bachelor's degree (p < 0.05 for all). Smoking, binge drinking, illicit drug use, and sleeping ≤6 h per night were associated with serious psychological distress (p < 0.05 for all). Conclusion: Among active-duty service members who utilized mental health services, 39.1 % reported serious psychological distress over the past year. Being separated, widowed, or divorced and having a lower education level were associated with serious psychological distress. Sex, race/ethnicity, and lesbian/gay/bisexual identity were not found to be correlated with the outcome. Additional research is needed to further explore these correlations to enhance military readiness.