Readiness for Change Predicts VA Mental Healthcare Utilization Among Iraq and Afghanistan War Veterans

Jakupcak, Matthew; Hoerster, Katherine D.; Blais, Rebecca K.; Malte, Carol A.; Hunt, Stephen C.; Seal, Karen H.

doi:10.1002/jts.21768

Cited by 26 publications

(23 citation statements)

References 22 publications

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“…Our findings highlight that timely service provision within the brief intervention and through referrals to long‐term services led to prompt attention to acute and chronic health conditions, relieved stress, and encouraged hopefulness and motivation to sustain engagement in the help‐seeking process. Conceptual models of recovery consistently highlight the importance of hope and goal‐setting (Leamy, Bird, Boutillier, Williams, & Slade, ; Mead & Copeland, ), and evidence indicates that internal motivation is an important predictor of reduced substance use (Collins, Malone, & Larimer, ) and mental health service utilisation (Jakupcak et al., ). While there is little evidence supporting any specific strategies to increase hopefulness, some qualitative work has suggested that experiences of success are generally helpful (Schrank, Bird, Rudnick, & Slade, ).…”

Section: Discussionmentioning

confidence: 99%

Promoting continuity of care for homeless adults with unmet health needs: The role of brief interventions

Lamanna

Stergiopoulos

Durbin

et al. 2017

Health Soc Care Community

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Promoting timely and continuous care for people experiencing homelessness has been a challenge in many jurisdictions, plagued by access barriers and service fragmentation. As part of a larger programme evaluation, this study used qualitative methods to examine the role of a brief interdisciplinary intervention in supporting continuity of care for this population in a large Canadian urban centre. The intervention provides time-limited case management, primary and psychiatric care, and peer accompaniment to homeless adults with unmet health needs discharged from hospital. Data were collected from 52 study participants between July 2013 and December 2014. Three focus groups were conducted with service providers and people with lived experience of homelessness, and 29 individual, semi-structured interviews were conducted with service users and other key informants. Transcripts were analysed using thematic analysis. Analysis was informed by existing frameworks for continuity of care, while remaining open to additional or unexpected findings. Findings suggest that brief interdisciplinary interventions can promote continuity of care by offering low-barrier access, timely and responsive service provision, including timely connection to long-term services and supports, appropriate individualised services and effective co-ordination of services. Although brief interdisciplinary interventions were perceived to promote access, timeliness and co-ordination of care for this population with complex health and social needs, gaps in the local service delivery context can present persisting barriers to care comprehensiveness and continuity. K E Y W O R D Sbrief interventions, continuity of care, homelessness, qualitative research, service co-ordination

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Section: Discussionmentioning

confidence: 99%

Promoting continuity of care for homeless adults with unmet health needs: The role of brief interventions

Lamanna

Stergiopoulos

Durbin

et al. 2017

Health Soc Care Community

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“…This corresponds with the 10-year increase in income observed for our respondents. The growing effort to incorporate brief interventions, including motivational interviewing, in general medical care is one possible avenue to improve perception of need and treatment utilization (Dawson et al, 2012; Jakupcak et al, 2013). …”

Section: Discussionmentioning

confidence: 99%

A 10-year study of factors associated with alcohol treatment use and non-use in a U.S. population sample

Chartier

Miller

Harris

et al. 2016

Drug and Alcohol Dependence

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Background This study seeks to identify changes in perceived barriers to alcohol treatment and predictors of treatment use between 1991–92 and 2001–02, to potentially help understand reported reductions in treatment use at this time. Social, economic, and health trends during these 10 years provide a context for the study. Methods Subjects were Whites, Blacks, and Hispanics. The data were from the National Longitudinal Alcohol Epidemiologic Survey (NLAES) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). We conducted two analyses that compared the surveys on: 1) perceived treatment barriers for subjects who thought they should get help for their drinking, and 2) variables predicting past-year treatment use in an alcohol use disorder subsample using a multi-group multivariate regression model. Results In the first analysis, those barriers that reflected negative beliefs and fears about seeking treatment as well as perceptions about the lack of need for treatment were more prevalent in 2001–02. The second analysis showed that survey year moderated the relationship between public insurance coverage and treatment use. This relationship was not statistically significant in 1991–92 but was significant and positive in 2001–02, although the effect of this change on treatment use was small. Conclusions Use of alcohol treatment in the U.S. may be affected by a number of factors, such as trends in public knowledge about treatment, social pressures to reduce drinking, and changes in the public financing of treatment.

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“…Initial results using brief motivational feedback have shown that veteran patients with comorbid substance dependence and psychiatric disorder were more likely to enter outpatient treatment groups compared to those veterans who did not receive brief motivational feedback (Lozano, LaRowe, Smith, Tuerk, & Rotzsch, 2013). Likewise, combat veterans who indicated a readiness for change at intake were more likely to utilize outpatient mental care resources (Jakupcak et al, 2013). …”

Section: Psychological Health Research Continuummentioning

confidence: 99%

The US framework for understanding, preventing, and caring for the mental health needs of service members who served in combat in Afghanistan and Iraq: a brief review of the issues and the research

Castro

2014

European Journal of Psychotraumatology

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This paper reviews the psychological health research conducted in the United States in support of combat veterans from Iraq and Afghanistan, using the Military Psychological Health Research Continuum, which includes foundational science, epidemiology, etiology, prevention and screening, treatment, follow-up care, and services research. The review is limited to those studies involving combat veterans and military families. This review discusses perplexing issues regarding the impact of combat on the mental health of service members such as risk and resilience factors of mental health, biomarkers of posttraumatic stress syndrome (PTSD), mental health training, psychological screening, psychological debriefing, third location decompression, combat and suicide, the usefulness of psychotherapy and drug therapy for treating PTSD, role of advanced technology, telemedicine and virtual reality, methods to reduce stigma and barriers to care, and best approaches to the dissemination of evidence-based interventions. The mental health research of special populations such as women, National Guardsmen and reservists, and military families is also presented. The review concludes by identifying future areas of research.

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Readiness for Change Predicts VA Mental Healthcare Utilization Among Iraq and Afghanistan War Veterans

Cited by 26 publications

References 22 publications

Promoting continuity of care for homeless adults with unmet health needs: The role of brief interventions

Promoting continuity of care for homeless adults with unmet health needs: The role of brief interventions

A 10-year study of factors associated with alcohol treatment use and non-use in a U.S. population sample

The US framework for understanding, preventing, and caring for the mental health needs of service members who served in combat in Afghanistan and Iraq: a brief review of the issues and the research

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