Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)

Legacy Department

International Family and Community Studies

Committee Member

Dr. Natallia Sianko, Committee Co-Chair

Committee Member

Dr. Thomas Britt

Committee Member

Dr. Bonnie Holaday


Objective: The underutilization of mental health services amongst military personnel is significant, especially among those who screen positive for mental health disorders. The factors that may deter or facilitate mental health utilization are varied and complex. The mechanisms through which these barriers and facilitators operate as well the conditions under which they have the most or least influence remain under examined. The current study examined factors associated with mental health service use and tested marital satisfaction as moderator of relationship between barriers to care and utilization and mental health symptoms and utilization. Method: The study analyzed data from anonymous surveys completed by 452 soldiers in Army combat units prior to deployment and three months post-deployment. Results: Education at post-deployment period, marital status at both time periods, and depression at both time periods were significantly associated with mental health utilization. Marital status and marital satisfaction did not moderate the relationship between barriers to care and utilization. Marital status was a significant predictor of utilization, with the greatest odds of utilization found to be among divorced soldiers, followed by married soldiers. PTSD was a predictor of mental health service utilization prior to deployment and following deployment. Marital satisfaction interacted with depression to predict utilization with the odds of utilization increasing among those with lower marital satisfaction. Conclusions: Marital relationships can play an important role in the military’s efforts to promote mental health service utilization. Further research should examine and interventions promote the conditions under which marital satisfaction can deter or facilitate mental health service utilization.


Dr. Mark Small, Committee Co-Chair



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