Who Uses Veterans Mental Health Services?: A National Observational Study of Male Veteran and Nonveteran Mental Health Service Users.


Journal

The Journal of nervous and mental disease
ISSN: 1539-736X
Titre abrégé: J Nerv Ment Dis
Pays: United States
ID NLM: 0375402

Informations de publication

Date de publication:
01 Oct 2021
Historique:
pubmed: 17 5 2021
medline: 4 1 2022
entrez: 16 5 2021
Statut: ppublish

Résumé

Mental health (MH) research among veterans receiving services from the Veterans Health Administration (VHA) is extensive and growing and informs many clinical practice guidelines. We used nationally representative survey data to examine the generalizability of this extensive body of research by comparing sociodemographic and clinical characteristics of male veteran veterans health service (VHS) users (n = 491) with veteran non-VHS users (n = 840) and nonveteran (n = 6300) MH service users. VHS users were older, more often reported Black race, and less likely to have private or Medicaid insurance, but had similar prevalence of psychiatric or substance use disorder diagnoses but with a greater prevalence of posttraumatic stress disorder (PTSD). VHS users reported higher rates of medical diagnoses, pain interference, and poorer physical and MH status. These results suggest that VHA MH research may be reasonably generalizable to US mental health service users with caveats regarding age, PTSD diagnosis, pain, and racial distribution.

Identifiants

pubmed: 33993183
doi: 10.1097/NMD.0000000000001369
pii: 00005053-202110000-00003
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

702-709

Informations de copyright

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Références

APHA (2014) Removing barriers to mental health services for veterans. Available at: https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2015/01/28/14/51/removing-barriers-to-mental-health-services-for-veterans . Accessed May 5, 2021.
Atkins D, Kilbourne AM, Shulkin D (2017) Moving from discovery to system-wide change: The role of research in a learning health care system: Experience from three decades of health systems research in the Veterans Health Administration. Annu Rev Public Health . 38:467–487.
Bialik K (2017) The changing face of America's veteran population. Pew Research Center Report . 2020. Available at: https://www.pewresearch.org/fact-tank/2021/04/05/the-changing-face-of-americas-veteran-population/ . Accessed May 3, 2021.
Bureau USC (2013) American Community Survey, 2012 . In U. S. C. Bureau (Ed). Suitland, MD: U.S. Department of Commerce.
Cohen S, Mermelstein R, Kamarck T, Hoberman HM (1985) Measuring the functional components of social support. In Sarason IG, Sarason BR (Eds), Social support: Theory, research and applications (pp 73–94). Dordrecht: Springer Netherlands.
Dahlhamer J, Lucas J, Zelaya C, Nahin R, Mackey S, DeBar L, Kerns R, Von Korff M, Porter L, Helmick C (2018) Prevalence of chronic pain and high-impact chronic pain among adults– United States, 2016. MMWR Morb Mortal Wkly Rep . 67:1001–1006.
Eibner C, Krull H, Brown KM, Cefalu M, Mulcahy AW, Pollard M, Shetty K, Adamson DM, Amaral EF, Armour P, Beleche T, Bogdan O, Hastings J, Kapinos K, Kress A, Mendelsohn J, Ross R, Rutter CM, Weinick RM, Woods D, Hosek SD, Farmer CM (2016) Current and projected characteristics and unique health care needs of the patient population served by the Department of Veterans Affairs. Rand Health Q . 5:13.
Ferguson CJ (2009) An effect size primer: A guide for clinicians and researchers. Prof Psychol Res Pract . 40:532–538.
Funk W (2020) Military Health System Basics. Prepared by Wendy Funk, Kennell and Associates. Available at: https://www.hsrd.research.va.gov/for_researchers/cyber_seminars/archives/2422-notes.pdf . Accessed May 3, 2021.
Goldberg SB, Fortney JC, Chen JA, Young BA, Lehavot K, Simpson TL (2020) Military service and military health care coverage are associated with reduced racial disparities in time to mental health treatment initiation. Adm Policy Ment Health . 47:555–568.
Grant B, Chu A, Sigman R, Amsbary M, Kali J, Sugawara Y, Jiao R, Ren W, Goldstein R (2015) National Institute on Alcohol Abuse and Alcoholism National Epidemiologic Survey on Alcohol and Related Conditions–III (NESARC-III) source and accuracy statement . Bethesda, MD: NIAAA.
Jorandby-Quinones L, Edens E, Rosenheck RA (2018) Co-occurring substance and mental health disorders. In Roberts LW, Warner CH (Eds), Military and veteran mental health (pp 307–333). New York, NY: Springer.
Kilbourne AM, Elwy AR, Sales AE, Atkins D (2017) Accelerating research impact in a learning health care system: VA's quality enhancement research initiative in the choice act era. Med Care . 55(suppl 7 suppl 1):S4–S12.
Kulka RA, Schlenger WE, Fairbank JA, Hough RL, Jordan BK, Marmar CR, Weiss DS (1990) Trauma and the Vietnam war generation: Report of findings from the National Vietnam Veterans Readjustment Study (pp xxix, 322-xxix, 322). Philadelphia, PA: Brunner/Mazel.
Landes SD, London AS, Wilmoth JM (2019) Service-connected disability and the veteran mortality disadvantage. Armed Forces Soc . 0095327X19884721. doi: 10.1177/0095327X19884721.
doi: 10.1177/0095327X19884721
Leslie DL, Rosenheck RA (2000) Comparing quality of mental health care for public-sector and privately insured populations. Psychiatr Serv . 51:650–655.
Levine D (2018) What are the obstacles to getting good mental health care for vets? U.S. News & World Report . Available at: https://health.usnews.com/health-care/patient-advice/articles/2018-03-30/what-are-the-obstacles-to-getting-good-mental-health-care-for-vets . Accessed May 3, 2021.
Manhapra A, Petrakis I, Rosenheck R (2017) Three-year retention in buprenorphine treatment for opioid use disorder nationally in the Veterans Health Administration. Am J Addict . 26:572–580.
Philipps D (2018) Suicide among veterans is rising. But millions for outreach went unspent by V.A. The New York Times . Available at: https://www.nytimes.com/2018/12/18/us/veterans-suicide-prevention.html . Accessed May 3, 2021.
Pitcher MH, Von Korff M, Bushnell MC, Porter L (2019) Prevalence and profile of high-impact chronic pain in the United States. J Pain . 20:146–160.
Rhee TG, Rosenheck RA (2019) Use of drug treatment services among adults with opioid use disorder: Rates, patterns, and correlates. Psychiatr Serv . 70:992–999.
Roberts LW, Warner CH (2018) Military and veteran mental health: A comprehensive guide . New York: Springer.
Rosenheck R, Fontana A (1995) Do Vietnam-era veterans who suffer from posttraumatic stress disorder avoid VA mental health services? Mil Med . 160:136–142.
Rosenheck R, Sorkin H, Stefanovics E (2020) Increasing the numbers of homeless veterans served by the Veterans Health Administration from 2008 to 2015: Maintaining focus on the intended target population and on sustaining service intensity. J Soc Distress Homeless . 1–11. Available at: https://doi.org/10.1080/10530789.2020.1753914 . Accessed May 6, 2020.
doi: 10.1080/10530789.2020.1753914
Rosenheck RA (2006) Mental health and substance abuse services for veterans: Experience with mental health performance evaluation in the Department of Veterans Affairs. In Institute of Medicine Committee on Crossing the Quality Chasm: Adaptation for Mental Health and Substance Abuse. Improving the Quality of Health Care for Mental and Substance-use Conditions (pp 423–482). Washington, DC: National Academies Press.
Rosenheck RA, Desai R, Steinwachs D, Lehman A (2000) Benchmarking treatment of schizophrenia: A comparison of service delivery by the national government and by state and local providers. J Nerv Ment Dis . 188:209–216.
Sacco P, Bucholz KK, Harrington D (2014) Gender differences in stressful life events, social support, perceived stress, and alcohol use among older adults: Results from a National Survey. Subst Use Misuse . 49:456–465.
SAS (2014) Statistical Analysis Software, ver. 9.4 . Cary, NC: SAS Institute Inc.
Sheehan CM, Hayward MD (2019) Black/White differences in mortality among veteran and non-veteran males. Soc Sci Res . 79:101–114.
Shekelle PG, Asch S, Glassman P, Matula S, Trivedi A, Miake-Lye I (2010) VA evidence-based synthesis program reports. In Comparison of quality of care in VA and non-VA settings: A systematic review . Washington, DC: Department of Veterans Affairs (US).
Steinhauer J (2016) Treated like a ‘piece of meat’: Female veterans endure harassment at the V.A. New York, NY. The New York Times . Available at: https://www.nytimes.com/2019/03/12/us/politics/women-veterans-harassment.html . Accessed May 3, 2021.
Steinhauer J (2019) V.A. officials, and the nation, battle an unrelenting tide of veteran suicides. The New York Times . Available at: https://www.nytimes.com/2019/04/14/us/politics/veterans-suicide.html . Accessed May 3, 2021.
VA (2016) VA mental health care fact sheet. Vol 2020. U.S. Department of Veteran Affairs. Available at: http://www.mentalhealth.va.gov/ , http://www.mentalhealth.va.gov/suicide_prevention/ . Accessed April 9, 2020.
VA (2017) Department of Veteran Affairs, National Center for Veteran Analysis and Statistics. Minority Veterans Report Military Service History and VA Benefit Utilization Statistics. 2020. Available at: https://www.va.gov/vetdata/docs/SpecialReports/Minority_Veterans_Report.pdf . Accessed May 29, 2020.
VA (2020a) Department of Veteran Affairs FY 2021 BUDGET SUBMISSION: Medical Programs and Information Technology Programs, Volume 2 of 4. In D. o. V. Affairs (Ed), Vol 2, p 460. Available at: https://www.va.gov/budget/docs/summary/fy2021VAbudgetVolumeIImedicalProgramsAndInformationTechnology.pdf . Accessed May 29, 2020.
VA (2020b) MIRECC/CoE. Available at: https://www.mirecc.va.gov . Accessed May 29, 2020.
VA (2020c) TRICARE Plans & Eligibility—Web page. Vol 2021. Available at: https://www.tricare.mil/Plans/Eligibility/RSMandFamilies . Accessed March 11, 2021.
VA (2020d) VA National Center On Homelessness Among Veterans. Vol 2020. Available at: https://www.va.gov/homeless/nchav/index.asp . Accessed May 29, 2020.
VA (2020e) VA Utilization Profile FY 2017. Vol 2021. Available at: https://www.va.gov/vetdata/docs/Quickfacts/VA_Utilization_Profile_2017.pdf . Accessed March 11, 2021.
VA (2020f) VA/DoD Clinical Practice Guidelines. Vol 2020. Available at: https://www.healthquality.va.gov . Accessed May 29, 2020.
VA (2021) VA Benefits and Healthcare. Vol 2021. Available at: https://www.va.gov/healthbenefits/resources/publications/hbco/hbco_basic_eligibility.asp . Accessed March 11, 2021.
Ware J Jr., Kosinski M, Keller SD (1996) A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Med Care . 34:220–233.
Watkins KE, Smith B, Akincigil A, Sorbero ME, Paddock S, Woodroffe A, Huang C, Crystal S, Pincus HA (2016) The quality of medication treatment for mental disorders in the Department of Veterans Affairs and in private-sector plans. Psychiatr Serv . 67:391–396.
Wong ES, Wang V, Liu CF, Hebert PL, Maciejewski ML (2016) Do Veterans Health Administration enrollees generalize to other populations? Med Care Res Rev . 73:493–507.

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