Exploring Associations Among U.S. Women Veterans between Mental Health Diagnoses and Self-Reported Negative Mental Health Days and Wellbeing Indicators

Background and Purpose

Wellbeing is a key goal and indicator of progress world-wide for civilian and military-connected populations (Adler and Gutierrez, 2023; Thompson et al 2022; Vogt et al 2019; MacLean, Roach, Banman, Mabior, & Pedlar, 2016). However, few studies specifically focus on women veterans’ experiences at all (Dodds and Kiernen, 2019), and fewer still on their wellbeing.

The primary purpose of this study is to explore associations between mental health diagnoses, self-reported negative mental health days, and multiple wellbeing indicators. Secondary purposes include: a) Examining how these associations intersect with race, ethnicity, sexual orientation, disability status and era of service; and b) Is there a point where multiple wellness indicators correlate with a decrease in poor mental health days? Findings will guide policy, practice, and research innovations to improve women veterans’ wellbeing.

Methods

The Assessing the Needs of Women Who Served in the U.S. Armed Forces Survey is the start of a participatory sequential mixed-methods exploratory study (Creswell, 2014) of the needs and wellbeing of U.S women veterans. We employed a web-based survey using modified snowball sampling to recruit women over 18 who had served in the U.S. Armed Forces. Nearly 6,000 participants started and 4,707 completed the survey, representing every U.S. state and branch of service. The sample race/ethnicity was white (75%), African American (11%), Hispanic (7%), American Indian/Alaska Native (3%), and Other (4%); and respondents were heterosexual (83%), lesbian/homosexual (8%), bisexual (5%), or other (4%). Most were 40 years older (80%).

The variables examined in the present analysis include self-report of having received a mental health condition; self-reported negative mental health days; self-reported physical health, mental health, spiritual health; sense of purpose; feelings of belonging; social support and connectedness; feeling loved; being resilient; and having the ability to pay monthly bills.

First, categorical and ordinal variables of interest will be tested with chi-square or Mann-Whitney tests to identify significant differences between the aspects of wellbeing for women veterans. Next, multivariate logistic regression will examine mental, financial, and spiritual wellbeing indicator variable differences among women veterans by demographic and service-related variables. All statistical tests will be two-sided with alpha set at 0.05.

Findings

Initial results show 60% reported getting physical help, 28% reported currently receiving mental health services, and an average of 47% reported their physical health, mental health, and spiritual health as good, very good, or excellent. We will present the results of the more complex analyses of relationships between mental health, wellbeing, and demographic variables at the conference.

Conclusion

More research is needed on the nature/complexity of women veteran’s wellbeing to guide future public policy and support. This includes developing an evidence-based understanding of the interactions between mental health, well-being, and demographic factors in both women veterans as a whole and subgroups of women veterans (e.g., women veterans of color, LGBTQ+ women veterans, women veterans with disabilities). This can pave the way for a more supportive and inclusive environment for all women veterans with attention to disability status, race, ethnicity, and sexual orientation.