Causal modeling of substance use and mental health among male military veterans

Objective: In order to understand the intersecting effects of race/ethnicity and military service on substance use and mental health, this study maps the unique differences between military and nonmilitary men in order to provide nuanced information for mental health professionals and behavioral interventionists in order to address mental health and other substance use disorders among military populations.Methods: Using structural equation modeling to examine mental health and substance use among male military veterans, this study sample contains information about 449 male veterans from the National Longitudinal Study of Adolescent to Adult Health (1994-2008): Waves I and IV in-home interviews. Results: Models for substance use and mental health patterns were not similar between veterans and non-veterans and or racial/ethnic groups. Overall, Pre-9/11 veterans, depression and anxiety significantly predicted higher cocaine use and higher prescription drug use. Among Post- 9/11 veterans, depression and PTSD predicted greater use of marijuana, methamphetamine and prescription medications. Conclusions: Study findings highlight opportunities for potential interventions and have implications for the design of substance use programs. The evidence from this study supports the need to develop integrated prevention interventions that build emotional resilience and coping mechanisms of participants with military service