Examining the impact of the veterans affairs community care program on mental healthcare in rural veterans: A qualitative study

ObjectiveTo investigate provider and administrators' perspectives about the impact of the Department of Veterans Affairs' (VA) Community Care program on acute and residential mental health treatment of rural Veterans.Data Sources and Study SettingPrimary data were collected from participants via interviews. Participants were employees of VA Healthcare Systems located in Northern New England, or employees of non-VA mental health treatment settings affiliated with VA in Northern New England.Study DesignThis study was informed by the Consolidated Framework for Implementation Research (CFIR), with Community Care as the implemented program. Individual, semi-structured interviews were conducted.Data Collection/Extraction MethodsIndividual interviews were transcribed, coded deductively using the CFIR, and inductively coded by locating themes.Principal FindingsTwenty-one people completed interviews. Commonly reported challenges included community programs not focused on Veterans' needs, poor coordination of care, communication challenges, and problems tracking Veteran care. Facilitators included increased access to care and strengthening coordination of care.ConclusionsThe VA's Community Care program can address the acute or residential mental health needs of Veterans in rural settings in some circumstances, however there are challenges to successful implementation.