A retrospective cohort study comparing the use of provincially funded mental health services between female military spouses living in Ontario and the general population

The spouses of military members experience frequent geographic mobility, absences, risk, and other lifestyle dimensions that may cause a greater need for mental health services and barriers to their use, relative to civilians. This was a retrospective, matched cohort study of female spouses of Canadian Armed Forces (CAF) members posted between 04/01/2008 and 03/31/2013 with follow-up to 03/31/2017. 3,358 military-connected spouses were identified and 13,342 civilians matched 4:1 on age, sex, and region of residence. Psychiatric hospitalizations and emergency department (ED) visits, psychiatrist visits, and mental health-related primary care visits were studied. Almost one third of spouses of CAF members visited a family physician for mental health reasons, while a minority visited an ED, a psychiatrist or were hospitalized. Spouses of CAF members were as likely to see a primary care physician, less likely to visit a psychiatrist, visited all measured outpatient sources of mental health services less frequently than the general population and had a longer interval to their first psychiatrist visit than the general population. Information on how mental health services are accessed in the public health system are critical to understanding pathways of care, and the planning and delivery of mental health services to military-connected families.