Self-perceptions of mental health among U.S. Veterans and non-Veterans: Behavioral Risk Factor Surveillance System, 2022.

INTRODUCTION: Veteran and other service member sub-populations have an increased likelihood of mental illness. Diagnosed mental health conditions among Veteran populations have been well described. However, direct self-perceptions of mental health have been under-researched. This study examined the association between Veteran status and self-perceived mental health in U.S. adults to provide better monitoring of frequent mental distress among Veteran populations. Methods: The 2022 Behavioral Risk Factor Surveillance System (BRFSS) cross-sectional telephone survey data were used in this analysis conducted in 2023. Weighted multinomial logistic regression was used to determine the association between Veteran status and reporting no (0), some (1-13), or frequent (≥14) days of mental distress, adjusted by key demographic, socio-economic, and health-related factors.

RESULTS: A total of 430,653 individuals were included in these analyses. In multivariate analyses, Veteran status was associated with decreased odds of reporting 1-13 poor mental health days (adjusted odds ratio [aOR] = 0.81, 95% CI, 0.77-0.86) compared to non-Veterans but greater odds of reporting ≥14 poor mental health days (aOR = 1.23, 95% CI, 1.15-1.33). Sex, age, marital status, race/ethnicity, education, annual income, employment status, health insurance, rurality, BMI, general health status, comorbid conditions, and poor physical health days were also significantly associated with poor mental health days in the final multivariate model..

DISCUSSION: Veterans are more likely to suffer from frequent mental distress than non-Veterans when considering demographic, socio-economic, and health-related characteristics. Validated methods for assessing perceived mental health should be standardized for comparable monitoring of mental distress and expansion of Veteran-centred care.