Reducing Barriers to Mental Health and Social Services for Iraq and Afghanistan Veterans: Outcomes of an Integrated Primary Care Clinic

Seal, Karen H.; Cohen, Greg; Bertenthal, Daniel; Cohen, Beth E.; Maguen, Shira; Daley, Aaron

doi:10.1007/s11606-011-1746-1

Cited by 43 publications

(25 citation statements)

References 54 publications

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“…Much of the current work focuses on improving rates of mental health utilization among patients already being seen in primary care (25,26). In this trial, success was dependent on the individual attending PTSD treatment attendance, and also in being able to navigate enrollment into the VA system.…”

Section: Discussionmentioning

confidence: 99%

RCT of a Brief Phone-Based CBT Intervention to Improve PTSD Treatment Utilization by Returning Service Members

Stecker¹,

McHugo²,

Xie³

et al. 2014

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Objectives Many service members do not seek care for mental health and addiction problems, often with serious consequences for them, their families, and their communities. This study tested the effectiveness of a brief, telephone-based, cognitive-behavioral intervention designed to improve treatment engagement among returning service members who screened positive for PTSD. Method OEF/OIF service members who screened positive for PTSD but had not engaged in PTSD treatment were recruited (N=300), randomly assigned to either control or intervention conditions, and administered the baseline interview. Intervention participants received the brief CBT intervention; control condition participants had access to usual services. All participants received follow-up phones calls at months 1, 3 and 6 to assess symptoms and service utilization. Results Participants in both conditions had comparable rates of treatment engagement and PTSD symptom reduction over the course of the six-month trial, but receiving the telephone-based intervention accelerated service utilization (treatment engagement and number of sessions) and PTSD symptom reduction. Conclusions A one-time brief telephone intervention can engage service members in PTSD treatment earlier than conventional methods and can lead to immediate symptom reduction. There were no differences at longer-term follow-up, suggesting the need for additional intervention to build upon initial gains.

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Section: Discussionmentioning

confidence: 99%

RCT of a Brief Phone-Based CBT Intervention to Improve PTSD Treatment Utilization by Returning Service Members

Stecker¹,

McHugo²,

Xie³

et al. 2014

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“…5,6 Perceived stigma associated with mental illness and practical, logistic barriers (e.g., living in rural areas, conflicting job schedule) reduce the likelihood a veteran will engage in, or receive, an adequate dose of psychotherapy. [7][8][9] Additionally, too few trained therapists and difficulty in accessing training hinder clinics' ability to provide EBPs for PTSD. 10 Thus, there is a gap between clinical practice and what practice guidelines recommend.…”

Section: Introductionmentioning

confidence: 99%

Implementation of Video Telehealth to Improve Access to Evidence-Based Psychotherapy for Posttraumatic Stress Disorder

Lindsay

Kauth

Hudson

et al. 2015

Telemedicine and e-Health

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Background: Increasing access to psychotherapy for posttraumatic stress disorder (PTSD) is a primary focus of the Department of Veterans Affairs (VA) healthcare system. Delivery of treatment via video telehealth can expand availability of treatment and be equally effective as in-person treatment. Despite VA efforts, barriers to establishing telehealth services remain, including both provider acceptance and organizational obstacles. Thus, development of specific strategies is needed to implement video telehealth services in complex healthcare systems, like the VA. Materials and Methods: This project was guided by the Promoting Action on Research Implementation in Health Services framework and used external facilitation to increase access to psychotherapy via video telehealth. The project was conducted at five VA Medical Centers and their associated community clinics across six states in the South Central United States. Results: Over a 21-month period, 27 video telehealth clinics were established to provide greater access to evidence-based psychotherapies for PTSD. Examination of change scores showed that participating sites averaged a 3.2-fold increase in unique patients and a 6.5-fold increase in psychotherapy sessions via video telehealth for PTSD. Differences between participating and nonparticipating sites in both unique patients and encounters were significant (p = 0.041 and p = 0.009, respectively). Two groups emerged, separated by degree of engagement in the facilitation intervention. Facilitation was perceived as useful by providers.

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“…Some may not be screened for MH problems or not encouraged to seek treatment for problems such as hazardous drinking behaviors. 10,11 Many wish to treat their problems on their own. 12 Many veterans and military personnel attach a stigma to MH treatment, especially SUDs, which they or their peers perceive as inconsistent with the mental toughness prized in the military.…”

Section: Introductionmentioning

confidence: 99%

Unmet Need for Treatment of Substance Use Disorders and Serious Psychological Distress Among Veterans: A Nationwide Analysis Using the NSDUH

et al. 2013

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Many veterans returning from Afghanistan and Iraq experience serious mental health (MH) concerns including substance use disorders (SUD), post-traumatic stress disorder, traumatic brain injury, depression, or serious psychological distress (SPD). This article uses data from the 2004 to 2010 National Survey on Drug Use and Health to examine the prevalence of unmet MH needs among veterans aged 21 to 34 in the general population. The prevalence of untreated SUD among veterans (16%) was twice as high as untreated SPD (8%), a nonspecific diagnosis of serious MH concerns. Surprisingly, similar rates of untreated SUD and SPD were found among a nonveteran comparison sample matched on gender and age. These findings suggest that reducing unmet need for MH treatment for veterans in the general population may require improving outreach to all Americans and creating greater acceptance for MH treatment. The need for further analyses of reasons for not obtaining treatment is discussed.

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Reducing Barriers to Mental Health and Social Services for Iraq and Afghanistan Veterans: Outcomes of an Integrated Primary Care Clinic

Cited by 43 publications

References 54 publications

RCT of a Brief Phone-Based CBT Intervention to Improve PTSD Treatment Utilization by Returning Service Members

RCT of a Brief Phone-Based CBT Intervention to Improve PTSD Treatment Utilization by Returning Service Members

Implementation of Video Telehealth to Improve Access to Evidence-Based Psychotherapy for Posttraumatic Stress Disorder

Unmet Need for Treatment of Substance Use Disorders and Serious Psychological Distress Among Veterans: A Nationwide Analysis Using the NSDUH

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