A Retrospective Examination of Service Dog Training Program Participation and Mental Healthcare Utilization



      : To investigate the association between Service Dog Training Program (SDTP) participation and mental healthcare utilization.


      : Retrospective cohort study.


      : Outpatient rehabilitation clinic at a large Military Treatment Facility (MTF).


      : Military Health System (MHS) beneficiaries who attended at least one SDTP session at a large MTF (N=597). SDTP program enrollment records identified subjects.


      : The SDTP, a unique application of Animal Assisted Therapy (AAT), is intended to improve the mental and cognitive health for individuals with war-related trauma.

      Main Outcome Measure(s)

      : Negative binomial regression calculated the associations between the SDTP participation rate and two mental healthcare utilization outcomes: mental health encounter days and psychotropic medication months’ supply.


      : Most of the 597 participants were male, enlisted service members, aged 25 to 34 years. Approximately 46% had a post-traumatic stress disorder (PTSD) diagnosis, 21% had a traumatic brain injury (TBI) diagnosis, 47% had an opioid prescription, and 58% had a sleep aid prescription pre-SDTP participation. Participation was categorized into low (≤1 sessions), medium (>1 and ≤2 sessions), and high (>2 sessions) monthly participation. In adjusted analysis, high monthly SDTP participation was associated with 18% fewer post-SDTP mental health encounter days (RR: 0.82, 95% CI: 0.68-0.96), as compared to low monthly SDTP participation. High monthly SDTP participation was also associated with a 22% fewer post-SDTP psychotropic prescription months’ supply (RR 0.78, 95% CI: 0.64-0.95), as compared to low monthly SDTP participation in adjusted analysis.


      : Results suggest that subjects who attend more than two SDTP sessions monthly encounter mental healthcare differently post-SDTP than subjects who attended one or fewer monthly sessions. Adjunct therapies, such as the SDTP, may offer patients a non-stigmatizing way to engage in mental healthcare.

      Key Words

      List of abbreviations:

      AAT (Animal Assisted Therapy), ADSM (Active Duty Service Members), CI (Confidence Interval), IQR (Interquartile Range), MDR (Military Health System Data Repository), MHS (Military Health System), MTF (Military Treatment Facility), PTSD (Post Traumatic Stress Disorder), RR (Rate Ratio), SDTP (Service Dog Training Program), TBI (Traumatic Brain Injury)
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