Retrospective Examination of Service Dog Training Program Participation and Mental Healthcare Utilization

Rebecca N Schulz; Kalyn C Jannace; Elizabeth J Hisle-Gorman; Paul F Pasquina

doi:10.1016/j.apmr.2022.07.009

Retrospective Examination of Service Dog Training Program Participation and Mental Healthcare Utilization

Arch Phys Med Rehabil. 2023 Feb;104(2):237-244. doi: 10.1016/j.apmr.2022.07.009. Epub 2022 Jul 30.

Authors

Rebecca N Schulz¹, Kalyn C Jannace², Elizabeth J Hisle-Gorman³, Paul F Pasquina⁴

Affiliations

¹ Uniformed Services University of Health Sciences, Bethesda, Maryland; Walter Reed National Military Medical Center, Bethesda, Maryland; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland. Electronic address: rebecca.schulz.ctr@usuhs.edu.
² Uniformed Services University of Health Sciences, Bethesda, Maryland; Walter Reed National Military Medical Center, Bethesda, Maryland; Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland.
³ Uniformed Services University of Health Sciences, Bethesda, Maryland.
⁴ Uniformed Services University of Health Sciences, Bethesda, Maryland; Walter Reed National Military Medical Center, Bethesda, Maryland.

PMID: 35917950
DOI: 10.1016/j.apmr.2022.07.009

Abstract

Objective: To investigate the association between Service Dog Training Program (SDTP) participation and mental health care utilization.

Design: Retrospective cohort study.

Setting: Outpatient rehabilitation clinic at a large military treatment facility.

Participants: Military Health System beneficiaries who attended at least 1 SDTP session at a large military treatment facility (N=597). SDTP program enrollment records identified participants.

Intervention: The SDTP, a unique application of animal-assisted therapy, is intended to improve the mental and cognitive health for individuals with war-related trauma.

Main outcome measures: Negative binomial regression calculated the associations between the SDTP participation rate and 2 mental health care utilization outcomes: mental health encounter days and psychotropic medication months' supply.

Results: Most of the 597 participants were male, enlisted service members, and aged 25-34 years. Approximately 46% had a posttraumatic stress disorder diagnosis, 21% had a traumatic brain injury diagnosis, 47% had an opioid prescription, and 58% had a sleep aid prescription pre-SDTP participation. Participation was categorized into low (≤1 sessions), medium (>1 and ≤2 sessions), and high (>2 sessions) monthly participation. In adjusted analysis, high monthly SDTP participation was associated with 18% fewer post-SDTP mental health encounter days (rate ratio [RR], 0.82; 95% confidence interval [CI], 0.68-0.96) than low monthly SDTP participation. High monthly SDTP participation was also associated with a 22% fewer post-SDTP psychotropic prescription months' supply (RR, 0.78; 95% CI, 0.64-0.95) than low monthly SDTP participation in adjusted analysis.

Conclusions: Results suggest that participants who attend more than 2 SDTP sessions monthly encounter mental health care differently post SDTP than participants who attended 1 or fewer monthly sessions. Adjunct therapies, such as the SDTP, may offer patients a nonstigmatizing way to engage in mental health care.

Keywords: Animal assisted therapy; Anxiety disorders; Military health; Mood disorders; Patient acceptance of health care; Psychotropic drugs; Rehabilitation; Service animals; Sleep disorders, circadian rhythm; Stress disorders, post-traumatic.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Animal Assisted Therapy*
Animals
Dogs
Female
Humans
Male
Patient Acceptance of Health Care
Retrospective Studies
Service Animals
Stress Disorders, Post-Traumatic* / psychology