AccScience Publishing / JCBP / Online First / DOI: 10.36922/JCBP025320060
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ORIGINAL RESEARCH ARTICLE

Quantitative analysis of the types of mental healthcare diagnosis and treatments provided by primary care providers in the department of defense (DoD)

Christopher E. Hines1* ,  Zachary Brooks1 ,  Justin C. Rissmiller1 ,  Nora L. Watson2
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1 NCC Military Psychiatry Residency Program, Walter Reed National Military Medical Center, Bethesda, Maryland, United States of America
2 Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, Maryland, United States of America
JCBP, 025320060 https://doi.org/10.36922/JCBP025320060
Received: 5 August 2025 | Revised: 15 October 2025 | Accepted: 22 October 2025 | Published online: 4 November 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

This study examines the frequencies of behavioral health diagnoses and treatments provided by primary care versus psychiatry, offering a framework for primary care providers and trainees to focus on prevalent behavioral healthcare needs. A retrospective analysis of 57 million primary care visits and 18 million behavioral healthcare visits from a Military Health System (MHS) database evaluated frequencies and proportions of specific mental health diagnoses from 2017 to 2021. The analysis compared percentages between direct and purchased care (PC) and further compared these to behavioral healthcare visits. A subset of data from the final year was also analyzed for psychotropic prescription patterns. Antidepressants were the predominant psychotropic medication class prescribed, accounting for more than all other classes combined. Prevalence ratios for common mental health diagnoses in primary care indicated that anxiety and depression diagnoses were less frequent in direct care versus PC for both active duty and dependents. However, adjustment disorder diagnosis in primary care was 2.59 times (95% confidence interval: 2.57, 2.61) more frequent in direct care versus PC in dependents. This study continues the evaluation of primary care behavioral health care provision trends in the MHS, providing crucial data for determining the training needed for primary care providers to appropriately treat mental health conditions. Understanding these patterns can help primary care providers confidently address the mental health conditions most encountered in practice.

Keywords
Primary care
Mental health
Military Health System
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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Journal of Clinical and Basic Psychosomatics, Electronic ISSN: 2972-4414 Print ISSN: 3060-8562, Published by AccScience Publishing
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