Discontinuation of mental health treatment among Canadian military personnel

Abstract: Introduction: Mental health problems are prevalent among Canadian Armed Forces (CAF) personnel. Despite ongoing efforts to promote mental health help seeking, treatment non-completion remains an overlooked issue in military settings. This study sought to provide estimates of past-year mental health treatment discontinuation among active CAF personnel, common reasons for discontinuation, and factors associated with treatment non-completion. Methods: Data from a nationally representative, cross-sectional mental health survey of active CAF Regular Force (RegF; n = 6,696) and Reserve Force (ResF; n = 1,469) personnel were analyzed. Predictors of treatment non-completion were examined using a series of logistic regressions. Results: Among RegF members, 20.8% sought mental health treatment in the past year. Of this sub-group, 38.4% discontinued all forms of treatment within the same year. Notably, only 26.6% of those who discontinued reported doing so because they completed the recommended course of treatment. Similar patterns were found among ResF personnel. Among RegF members, higher education, being married or in a common-law relationship, being a senior non-commissioned member, having a history of childhood maltreatment, and lower social support were associated with an increased likelihood of treatment non-completion. Common reasons for non-completion included feeling better, thinking treatment was not helping, and not being comfortable with the approach. Discussion: This study highlights the complexities of military mental health services provision and offers the first nationally representative analysis of treatment discontinuation in a Canadian military population. Recognizing the reasons for treatment discontinuation may enable future initiatives designed to enhance treatment completion among active military personnel.