(PS3-34) Relationships Between Social Determinants of Health, Symptom Severity, and Treatment Outcomes for Military-connected Clients with Depression

Social determinants of health impact mental health conditions and treatment outcomes, particularly for individuals with the least access to socioeconomic resources and opportunities (Alegría et al., 2019; Fisher and Baum, 2010). Among military veterans, disparities in social determinants of health are linked to higher rates of depression and post-traumatic stress disorder (Holder et al., 2023), suicidal ideation (Bloshich et al., 2020), and poorer general health and functioning (Hoerster et al., 2012; Lehavot et al., 2012). Lack of social support, economic instability, and employment insecurity are associated with greater depression symptoms among both veterans and non-veterans (Holder et al., 2023), however additional research is needed to understand the impacts of these factors on outcomes of mental health treatments.  

In 2023, Cohen Veterans Network (CVN) served 1,052 adult clients with depression across 24 outpatient mental health clinics in the US. Approximately 49% of these clients reported experiencing at least one disadvantage related to a social determinant of health.  However, gaps persist in our understanding of how different social determinants of health are associated with symptom severity for CVN clients with depression and their treatment outcomes. The purpose of this study is to examine the prevalence of social determinants of health and the relationship between these experiences and symptom severity and treatment outcomes within a national mental health network serving veterans, active-duty service members, and military families. 

This project has three primary aims; first, we will determine the prevalence of four social determinants of health (lack of social support, lack of family support, economic instability, and insecure employment) among adult clients with depression. Second, we will utilize multiple regression to examine the association between these four determinants and depression symptom severity at intake (as measured by the PHQ-9). Third, we will examine the relationship between these four social determinants of health on symptom severity at discharge using an ANCOVA model, which allows us to account for intake scores and the four social determinants. This research will contribute to broader understandings of the role of social determinants of health in symptom severity and treatment outcomes for mental health concerns. Findings will inform future research and network policies aimed at addressing disparities in social determinants of health alongside traditional mental health treatments.