Retrospective and prospective examination of outpatient mental health utilization and military career impacts.

United States (U.S.) military personnel express concerns about the potential impact of seeking mental health care on their careers. To date, there is a lack of empirical data on the association between mental health treatment utilization at a military treatment facility and career-related outcomes. This study examined short- and long-term military career outcomes among U.S. Air Force (USAF) personnel receiving outpatient mental health care. Phase 1 involved a retrospective chart review (N = 370) across nine USAF mental health outpatient clinics. Phase 2 involved a prospective case control comparison of the career-trajectories of USAF personnel who sought mental health treatment (n = 332) versus those who did not (n = 1147) after matching for military rank, time in grade, and occupational code. Overall, nearly a third of service members received career-affecting recommendations from their mental health treatment provider. Commander-directed service members were more likely to receive career-affecting recommendations than those self-referred or superior-encouraged. Younger age, higher rank, superior-encouraged referral, greater self-reported distress during first contact, and history of psychiatric inpatient care were predictors of receiving career-affecting recommendations. Service members receiving outpatient mental health care, compared to those without a military history of mental health care, were three times more likely to experience a medical board evaluation and nearly twice as likely to receive a discharge. Proactive, early self-referral for mental health treatment is one strategy for sustaining a military career. Department of Defense stigma reduction campaigns should provide empirically derived information about mental health treatment utilization and military career-related outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved)