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Technology Playing Role in Veterans’ Access to Mental Health Services

     

As we approach Veterans Day and look to honor the work and sacrifices of members of the military and their families, we look at several recent reports on veterans and mental health services.

Use of VA Mental Health Services
The COVID-19 pandemic has taken a toll on the mental health of individuals in the U.S., but, even before the pandemic, mental health was a long-term and growing concern for veterans, a new U.S. Government Accountability Office (GAO) report notes.(1) The number of veterans receiving mental health care from the Department of Veterans Affairs increased 90% from FY 2006-2019, and an estimated one-third of its patient population has one or more mental health conditions.

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Description automatically generatedVeteran mental health visits via telehealth increased by over 200% in the first 8 months of the pandemic. In February 2021, 77% percent of VA mental health visits were telehealth visits. While these numbers show the adaption of telehealth during the pandemic, and VA conducts outreach to raise awareness of mental health services, still some veterans may not be aware of the services and benefits available to them, according to the report.

Preventing Veteran Suicide
Preventing suicide is a high priority at the VA. Its most recent report on suicide prevention notes the number of veteran suicides increased from 2001 to 2018 but decreased from 2018 to 2019. (2) Veterans between the ages of 55-74 were the largest population subgroup; they accounted for 38.6% of Veteran suicide deaths in 2019. While data from 2019 is the most recent suicide data available, the report notes a review of suicide-related indicators during the pandemic did not find increases.

The report also highlights efforts by the VA to prevent suicides, such as the Veteran’s Crisis Text line, available 24/7 through phone, chat, and text for all veterans, service members and their family members and friends.

Women Veterans
Women make up a growing share of the veteran population — about 1.7 million, or 9% of veterans, were women in 2018. Sixty-four percent of women veterans of recent military conflicts (post-9/11) have received health care through the VA, according to a recent study looking at women veterans’ timely access to mental health care.(3) Between 2005 and 2015 the number of women veterans who used VA more than doubled, and there was a 49% increase in the proportion of woman veteran VA-users who accessed its mental health services.

A 2019 study in Psychological Services found that 59% reported “always” and 22% report “usually” getting an appointment for mental health care as soon as needed. Most rated mental health and primary care at VA very high and more than 90% indicated they would recommend or strongly recommend VA to other women veterans.

The study noted two areas of concern in particular: challenges scheduling visits around other obligations (such as work and childcare) and a lack of ability to get questions answered in between appointments. The study authors suggest increasing the use of telehealth and expanding hours could boost access and that increasing communication with mental health professionals between visits might reduce the need for full visits.

Veterans in Rural Areas
The majority of VA hospitals are in urban areas, and researchers examined whether veterans residing in rural areas have lower mental health service use and poorer mental health status. Among veterans, living in a rural area was associated with lower mental health service use, butnot with poor mental health. The study authors concluded that “rural residence is possibly protective.”(4)

Older Veterans
The VA offers a number of technology-delivered interventions to self-manage mental health problems and researchers examined the barriers to their use, especially among older veterans. (5)  In the study, more than 80% of the older veterans had a computer and internet access at home; more than 70% had smart phones. When asked about their preferences for format of self-management interventions, two-thirds preferred some type of technology — 29% mobile apps, 25% internet and 13% DVDs — while 35% preferred printed materials. The older veterans also showed a strong preference for counseling over self-management interventions, two-thirds of older veterans preferred counseling when given the choice.

 

References

(1) Government Accounting Office. Veterans' Growing Demand for Mental Health Services. GAO-21-545SP. May 17, 2021.
(2)  U.S. Department of Veterans Affairs. National Veteran Suicide Prevention Annual Report. September 2021
3) Brunner, J, et al. Timely Access to Mental Health Care among Women Veterans.  Psychol Serv. 2019 Aug; 16(3): 498–503. doi: 10.1037/ser0000226
(4) Boscarino J., et al. Mental health status in veterans residing in rural versus non-rural areas: results from the veterans' health study. Mil Med Res   . 2020 Sep 21;7(1):44. doi: 10.1186/s40779-020-00272-6.
(5) Gould, C.E., et al. Technology use and preferences for mental health self-management interventions among older veterans. Int J Geriatr Psychiatry. 2020 Mar;35(3):321-330.   doi: 10.1002/gps.5252

     

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