In Reply We appreciate the interest of Smith and Vipler in our study.1 The 2 internal medicine physicians raise 3 concerns regarding our findings about the prevalence of comorbid mental health conditions among service members following a concussive blast injury.
First, “increased awareness allows individuals to seek out mental health care regardless of …cause.” The report that they cite encourages, not discourages, this point. This was recommended because it was believed to reduce severity and poor outcome, not increase it. That said, we inquired about treatments with all of service members in our study (controls and patients with a concussion). We found that “80% of concussive blast patients endorsed seeking assistance from a mental health care professional. Only….18% reported that mental health programs helped.”1 (p825) Most did not repeatedly seek treatment as suggested because they felt that it did not help.
Mac Donald CL, Fann JR, Temkin NR. Mild Traumatic Brain Injury and Mental Health—Reply. JAMA Neurol. 2017;74(11):1378. doi:10.1001/jamaneurol.2017.2771
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