Mental health literacy in veterans: What do U.S. military veterans know about PTSD and its treatment?

Williston, Sarah Krill; Vogt, Dawne

doi:10.1037/ser0000501

Cited by 11 publications

(10 citation statements)

References 28 publications

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“…Lastly, patient education about the availability of mental health treatments for PTSD, such as psychotropic medications and evidence-based psychotherapies, may be helpful to increase initiation in mental health treatment. A recent study found that veterans have greater knowledge of PTSD symptoms and etiology but less knowledge about evidence-based treatment options (Williston & Vogt, 2021); therefore, improving patient knowledge about treatment options and benefits of treatment may help increase engagement in mental health treatment.…”

Section: Discussionmentioning

confidence: 99%

Discrepancies between electronic records and clinical interview diagnosis of PTSD: Differences in mental health care utilization.

Harper

Ellickson‐Larew

Bovin

et al. 2022

Psychological Services

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Prior research suggests that a significant number of veterans with posttraumatic stress disorder (PTSD) do not have this diagnosis recognized in the electronic health record (EHR). Unfortunately, such diagnostic errors can lead to improper allocation of already scarce health care services and resources. In this study, we examined concordance between PTSD diagnoses in the Veterans Affairs (VA) EHR and PTSD diagnoses based on a semistructured diagnostic interview and mental health service use in a sample of veterans (N = 1,299) enrolled in VA healthcare. Results from negative binomial regressions showed that veterans with PTSD based on the diagnostic interview and the EHR (true positives) used the most mental health care services. There were no significant differences between those without PTSD based on the interview and the EHR (true negatives) and those with PTSD based on interview that was not recognized in the EHR (false negatives) on total nonemergent outpatient mental health visits. However, veterans in the false negative group had more mental health-related emergent care visits (i.e., emergency room, urgent care, hospitalization) than veterans in the true negative group. Our findings suggest that veterans with PTSD who are not coded as such in the EHR may not be utilizing needed outpatient care but are seeking and receiving costly emergent care. Thus, accurate recognition of PTSD in the EHR is essential for connecting patients to outpatient mental health services. Impact StatementThis study suggests that veterans with PTSD that have not been recognized as having PTSD in the electronic health record underutilize outpatient mental health services but have greater emergency service use (e.g., hospitalizations) than veterans without PTSD. Therefore, accurate diagnosis and coding of PTSD in electronic health records is important for connecting veterans with needed care.

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Section: Discussionmentioning

confidence: 99%

Discrepancies between electronic records and clinical interview diagnosis of PTSD: Differences in mental health care utilization.

Harper

Ellickson‐Larew

Bovin

et al. 2022

Psychological Services

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“…Veterans with marginal health literacy experience worse quality of care and outcomes and increased, unnecessary, and burdensome health care costs. 10,11,33 Limited health literacy is also strongly associated with poor quality of life and low rates of cancer treatment adherence. [34][35][36][37][38] Routine health literacy screening and associated, tailored interventions are needed.…”

Section: Discussionmentioning

confidence: 99%

“…5 Etiologies for these disparities include distance from facilities, with over 4.7 million Veterans living in rural areas up to 1,000 miles from the nearest Veterans Affairs (VA) clinic, limited health literacy, higher rates of complex comorbidities including mental health disorders, and social and economic challenges that can inhibit evidence-based lung cancer care receipt. [6][7][8][9][10][11] Despite efforts to optimize lung cancer care delivery in the VA, few studies have evaluated Veterans' experiences with lung cancer care and opportunities to improve care from their perspective. The goal of this study, therefore, was to understand lung cancer care delivery barriers and potential solutions to overcome barriers firsthand from Veterans.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Understanding Barriers and Facilitators to High-Quality Cancer Care Among Veterans With Lung Cancer: A Qualitative Study

Lopez,

Murillo,

Das

et al. 2023

JCO Oncol Pract

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PURPOSE Veteran populations have higher lung cancer incidence and worse overall survival compared with non-Veteran populations. Although recent clinical advancements have reduced lung cancer death rates, these advances are not routinely received among Veteran populations because of multilevel factors, including Veterans' complex comorbidities, limited health literacy, and other economic and social disadvantages. This study aimed to assess Veterans' perspectives regarding their lung cancer care with a specific focus on identifying modifiable barriers to evidence-based care delivery. METHODS We conducted 1:1 semistructured interviews with 24 Veterans diagnosed with lung cancer at the Veterans Affairs Palo Alto Health Care System. All interviews were recorded, transcribed, and analyzed using the constant comparative method of qualitative analysis. RESULTS Four themes emerged. These included (1) social and economic disadvantages can prevent routine delivery of evidence-based cancer care; (2) fragmented care contributes to worsening patient mental and emotional well-being; (3) lack of health system interventions to address limited health literacy inhibits patient engagement in shared decision making regarding diagnosis, genomic and molecular testing, targeted and other treatments, and end-of-life care; and (4) deep appreciation for care and VA trustworthiness facilitates adherence to cancer care recommendations. CONCLUSION This study revealed critical gaps in lung cancer care delivery and the role of institution-engendered trust in overcoming barriers in the VA system. Targeted solutions should address the identified barriers to routine, evidence-based lung cancer care delivery among Veterans.

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“…However, recent research indicates less than optimal mental health literacy within military and veteran populations. Williston and Vogt (2021) found that veterans with PTSD showed relatively good levels of PTSD problem recognition; 93% of participants correctly identified PTSD symptoms. In contrast, participants demonstrated substantially lower levels of knowledge about effective mental health treatments; only 37% and 28% correctly identified prolonged exposure and cognitive processing therapy as effective treatments, respectively.…”

mentioning

confidence: 97%

Primary Care Veteran Preferences for Receiving Information about Mental Health Services: Cross-Sectional Survey

Hampton¹,

Johnson²,

Buckheit³

et al. 2022

Journal of Veterans Studies

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The purpose of this study was to understand contextual characteristics of how veterans in primary care prefer to receive mental healthcare information (i.e., information about mental health symptoms/services) in terms of provider, location, and format. One hundred sixteen primary care veterans with behavioral health concerns (58% depression, 37% PTSD, 50% hazardous alcohol use) participated in a cross-sectional phone and mail survey. Forty-seven percent had recently received mental health services; Fifty-three percent had not. Overall, veterans preferred receiving mental health information from behavioral health providers (n = 55, 47%) and via individual face-to-face communication (n = 65, 56%). However, veterans without recent mental health treatment were more likely to endorse home as their most preferred location (n = 18, 29%) and mailed selfhelp materials as their most preferred format (n = 11, 18%) compared to veterans with recent mental health treatment. Veterans with recent mental health treatment were more likely to endorse Veterans Affairs behavioral health clinics as their most preferred location (n = 23, 43%) and face-to-face communication as their most preferred format (n = 37, 69%) compared to veterans without recent mental health treatment. When tailoring mental health communication to veterans with behavioral health concerns, findings suggest that recent mental health treatment history is an important distinction. These results can inform development of public health messaging, decision aids, and psychoeducational material for veterans. Future research should evaluate the impact of age, gender, and service era on preferences to better understand how to tailor messaging and materials to more specific groups of veterans.

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Mental health literacy in veterans: What do U.S. military veterans know about PTSD and its treatment?

Cited by 11 publications

References 28 publications

Discrepancies between electronic records and clinical interview diagnosis of PTSD: Differences in mental health care utilization.

Discrepancies between electronic records and clinical interview diagnosis of PTSD: Differences in mental health care utilization.

Understanding Barriers and Facilitators to High-Quality Cancer Care Among Veterans With Lung Cancer: A Qualitative Study

Primary Care Veteran Preferences for Receiving Information about Mental Health Services: Cross-Sectional Survey

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