Prevalence of Stranger Harassment of Women Veterans at Veterans Affairs Medical Centers and Impacts on Delayed and Missed Care

Abstract

Background: Harassment of servicewomen during military service has been well-documented, but harassment of women veterans in Veterans Affairs (VA) health care settings has not been studied systematically. We assessed the prevalence and impacts of harassment among women veterans who use VA health care. Methods: From January to March 2015, we conducted computer-assisted telephone interviews of randomly sampled women veterans with three or more primary care and/or women's health visits at 1 of 12 VA medical centers. We asked if patients had experienced inappropriate/unwanted comments or behavior from male veterans at VA in the past year. We measured sociodemographics, health status, perceptions of VA care, delayed/unmet health care need, and care preferences. All analyses were weighted to account for the disproportionate sample design and nonresponse. Brief, open-ended descriptions of harassment were transcribed and coded. Results: Approximately one in four women veterans (25.2%; n ¼ 1,395, response rate 45%) reported inappropriate/unwanted comments or behavior by male veterans on VA grounds. Site prevalence ranged from 10% to 42%. Incident descriptions were wide-ranging (e.g., catcalls, sexual/derogatory remarks, propositioning, stalking, and denigration of veteran status). Reports of harassment were more common among women with histories of military sexual trauma; other trauma exposures (e.g., combat, childhood); positive screens for anxiety, depression, and/or posttraumatic stress disorder; and fair/poor health. Those who reported harassment were significantly less likely to report feeling welcome at VA, and more likely to report not feeling safe, and delaying/missing care.

Veterans' satisfaction and perspectives on helpfulness of the Veterans Crisis Line

“…This approach resulted in 155 completed interviews (38.7%). Other studies of Veterans surveyed by telephone have included rates ranging from 22.7% to 32.5% when calculated based on the number of respondents compared to the number of those initially identified as potential participants (Callegari et al, 2017; Klap et al, 2019; Resnik et al, 2019).…”

Association of Veterans Affairs Primary Care Mental Health Integration With Care Access Among Men and Women Veterans

“…One in 4 women veterans have reported harassment from men in VA facilities, an experience that has been associated with their delaying or missing care. 11 During the past decade, the VA invested resources to improve mental health care access through the national Primary Care-Mental Health Integration (PC-MHI) initiative, 12 but we do not know if the improvements similarly benefitted men and women veterans. The PC-MHI initiative generally targets increased access to effective depression and other mental health treatments for veterans.…”

The Focus They Deserve: Improving Women Veterans’ Health Care Access

“…Participants' perspectives reinforced findings describing women veterans' preferences about care environments and perceptions about VHA facilities associated with VHA use and attrition (Evans, Tennenbaum, Washington, & Hamilton, 2019;Hamilton, Frayne, Cordasco, & Washington, 2013;Kehle-Forbes et al, 2017;Klap et al, 2019;Mengeling, Sadler, Torner, & Booth, 2011). Participants perceived that some VHA facilities were unwelcoming, hostile, or unsafe for women veterans, as reported in other studies (Dyer et al, 2019;Evans et al, 2019;Kehle-Forbes et al, 2017;Klap et al, 2019;Washington, Yano, & Simon, 2006). Our evaluation highlights staff and providers' efforts to address access barriers, including increasing provider training in gender-sensitive care, developing more private clinic spaces for on-site care, and by offering alternative options to receive care (e.g., telehealth, community care).…”