Veteran's Experiences Initiating VA-Based Mental Health Care

被引:25
作者
Bovin, Michelle J. [1 ,2 ]
Miller, Christopher J. [3 ,4 ]
Koenig, Christopher J. [5 ,6 ]
Lipschitz, Jessica M. [3 ,4 ]
Zamora, Kara A. [7 ]
Wright, Patricia B. [8 ]
Pyne, Jeffrey M. [9 ,10 ,11 ]
Burgess, James F., Jr. [3 ,12 ]
机构
[1] Vet Affairs Boston Healthcare Syst, Natl Ctr PTSD, 116B-4,150 South Huntington Ave, Boston, MA 02130 USA
[2] Boston Univ, Sch Med, Dept Psychiat, Boston, MA 02215 USA
[3] Vet Affairs Boston Healthcare Syst, Ctr Healthcare Org & Implementat Res, Boston, MA USA
[4] Harvard Med Sch, Dept Psychiat, Boston, MA 02115 USA
[5] San Francisco State Univ, Dept Commun Studies, San Francisco, CA 94132 USA
[6] Palo Alto Healthcare Syst, Palo Alto, CA USA
[7] San Francisco Vet Affairs Healthcare Syst, San Francisco, CA USA
[8] Univ Arkansas Med Sci, Coll Nursing, Little Rock, AR 72205 USA
[9] Cent Arkansas Vet Healthcare Syst, Ctr Mental Healthcare & Outcomes Res, North Little Rock, AR USA
[10] Cent Arkansas Vet Healthcare Syst, South Cent Mental Illness Res Educ & Clin Ctr, North Little Rock, AR USA
[11] Univ Arkansas Med Sci, Div Hlth Serv Res, Dept Psychiat, Coll Med, Little Rock, AR 72205 USA
[12] Boston Univ, Sch Publ Hlth, Hlth Law Policy & Management Dept, Boston, MA 02215 USA
关键词
mental health; access; veteran; qualitative; PERCEIVED BARRIERS; SERVICES; PERSPECTIVES; PERCEPTIONS; AFGHANISTAN; BELIEFS; PATIENT; IRAQ;
D O I
10.1037/ser0000233
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Military veterans who could benefit from mental health services often do not access them. Research has revealed a range of barriers associated with initiating United States Department of Veterans Affairs (VA) care, including those specific to accessing mental health care (e.g., fear of stigmatization). More work is needed to streamline access to VA mental health-care services for veterans. In the current study, we interviewed 80 veterans from 9 clinics across the United States about initiation of VA mental health care to identify barriers to access. Results suggested that five predominant factors influenced veterans' decisions to initiate care: (a) awareness of VA mental health services; (b) fear of negative consequences of seeking care; (c) personal beliefs about mental health treatment; (d) input from family and friends; and (e) motivation for treatment Veterans also spoke about the pathways they used to access this care. The four most commonly reported pathways included (a) physical health-care appointments; (b) the service connection disability system; (c) non-VA care; and (d) being mandated to care. Taken together, these data lend themselves to a model that describes both modifiers of, and pathways to, VA mental health care. The model suggests that interventions aimed at the identified pathways, in concert with efforts designed to reduce harriers, may increase initiation of VA mental health-care services by veterans.
引用
收藏
页码:612 / 620
页数:9
相关论文
共 39 条
[1]  
[Anonymous], NY TIMES
[2]   Behavioral Health and Health Care Reform Models: Patient-Centered Medical Home, Health Home, and Accountable Care Organization [J].
Bao, Yuhua ;
Casalino, Lawrence P. ;
Pincus, Harold Alan .
JOURNAL OF BEHAVIORAL HEALTH SERVICES & RESEARCH, 2013, 40 (01) :121-132
[3]   Same-Day Integrated Mental Health Care and PTSD Diagnosis and Treatment Among VHA Primary Care Patients With Positive PTSD Screens [J].
Bohnert, Kipling M. ;
Sripada, Rebecca K. ;
Mach, Jennifer ;
McCarthy, John F. .
PSYCHIATRIC SERVICES, 2016, 67 (01) :94-100
[4]  
Braun V., 2006, QUAL RES PSYCHOL, V3, P77, DOI [DOI 10.1191/1478088706QP063OA, 10.1191/1478088706qp063oa]
[5]   Veterans' perceptions of care by nurse practitioners, physician assistants, and physicians: A comparison from satisfaction surveys [J].
Budzi, Dorothy ;
Lurie, Sue ;
Singh, Karan ;
Hooker, Roderick .
JOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, 2010, 22 (03) :170-176
[6]  
Burnett-Zeigler I, 2011, PSYCHIAT SERV, V62, P1054, DOI 10.1176/appi.ps.62.9.1054
[7]   Distance is Relative: Unpacking a Principal Barrier in Rural Healthcare [J].
Buzza, Colin ;
Ono, Sarah S. ;
Turvey, Carolyn ;
Wittrock, Stacy ;
Noble, Matt ;
Reddy, Gautam ;
Kaboli, Peter J. ;
Reisinger, Heather Schacht .
JOURNAL OF GENERAL INTERNAL MEDICINE, 2011, 26 :S648-S654
[8]  
Drapalski AL, 2008, PSYCHIAT SERV, V59, P921, DOI 10.1176/ps.2008.59.8.921
[9]  
Duffy M E, 1987, Nurs Health Care, V8, P356
[10]   Are Iraq and Afghanistan Veterans Using Mental Health Services? New Data From a National Random-Sample Survey [J].
Elbogen, Eric B. ;
Wagner, H. Ryan ;
Johnson, Sally C. ;
Kinneer, Patricia ;
Kang, Han ;
Vasterling, Jennifer J. ;
Timko, Christine ;
Beckham, Jean C. .
PSYCHIATRIC SERVICES, 2013, 64 (02) :134-141