Although the Veterans Health Administration (VA) has recently adopted new policies encouraging gender-specific mental health (MH) care delivery to women veterans, little is known about the potential difficulties local facilities may face in achieving compliance. We assessed variations in women's mental health care delivery arrangements in VA facilities nationwide.
We used results from the VA Survey of Women Veterans Health Programs, a key informant survey of senior women's health clinicians representing all VA facilities serving more than 300 women veterans, to assess the array of gender-sensitive mental health care arrangements (response rate, 86%; n = 195). We also examined organizational and area factors related to availability of women's specialty mental health arrangements using multivariable logistic regression.
Nationally, over half (53%) of VA facilities had some form of gender-sensitive mental health care arrangements. Overall, 34% of sites reported having designated women's mental health providers in general outpatient mental health clinics (MHCs). Almost half (48%) had therapy groups for women in their MHCs. VAs with women's primary care clinics also delivered mental health services (24%), and 12% of VAs reported having a separate women's MHC, most of which (88%) offered sexual trauma group counseling. Assignment to same-gender mental health providers is not routine. VAs with comprehensive women's primary care clinics were more likely to integrate mental health care for women as well.
Local implementation of gender-sensitive mental health care in VA settings is highly variable. Although this variation may reflect diverse local needs and resources, women veterans may also sometimes face challenges in accessing needed services.
"ely than the VA to have SUD programs and groups exclusively for women , the VA could also focus on connecting women veterans with non - federal providers rather than trying to replicate those treatment options within the VA without a critical mass of women to support them . As in previous work on primary and mental health care for women veterans ( Oishi et al . , 2011 ; Washington et al . , 2011 ) , the availability of SUD programs and key services for women varied by the geographic factors of region and urbanicity . More urban areas were more likely to have a greater array of key services , which may reflect the VA ' s establishment of comprehensive women ' s health centers in academic medical cente"
[Show abstract][Hide abstract] ABSTRACT: Gender is an important consideration in the treatment of substance use disorders (SUD). Although the number of women seeking care through the Department of Veterans Affairs (VA) has increased dramatically, little is known about the capacity of the VA to meet the needs of women with SUD. We examined the prevalence of programs and key services for women in VA facilities in a survey of 14,311 SUD treatment facilities.
Using data from the 2012 National Survey of Substance Abuse Treatment Services, we calculated the percent of VA facilities offering special programs or groups exclusively for women, compared with facilities under other types of ownership. For each ownership type, we also calculated the mean number of ancillary services offered that are critical for many women in SUD treatment, including child care, domestic violence counseling, and transportation assistance. Multivariable models were used to adjust for differences in other facility characteristics.
Approximately 31% of facilities had special programs exclusively for women. The VA had the lowest prevalence of programs for women, at 19.1%; however, the VA offered an average of 5 key services for women, which was significantly higher than the averages for other federal (n = 2), local (n = 4), and private for-profit (n = 2) facilities. Results were generally robust to multivariable adjustments.
The VA should consider developing more SUD programs and groups exclusively for women, while maintaining ancillary services at their relatively abundant level. Gender-specific programs and groups could serve as points of referral to ancillary services for women veterans.
Published by Elsevier Inc.
Women s Health Issues 08/2015; DOI:10.1016/j.whi.2015.07.005 · 1.61 Impact Factor
"d approach . When these gender related preferences are met , women report significantly better access , with an increased likelihood of reporting that mental health care met their needs ( Kimerling et al . 2015 ) . The organization and availability of specialized mental health services for women varies greatly across VHA ( MacGregor et al . 2011 ; Oishi et al . 2011 ) , and given the small numbers of women in some facilities , a full range of designated women ' s clinics , groups , or other services within specialty mental health may not always be feasible or available . If more activated women are better able to express gender - related preferences to providers and engage shared deci - sion making"
[Show abstract][Hide abstract] ABSTRACT: We utilized a nationally representative survey of women veteran primary care users to examine associations between patient activation and mental health care experiences. A dose-response relationship was observed, with odds of high quality ratings significantly greater at each successive level of patient activation. Higher activation levels were also significantly associated with preference concordant care for gender-related preferences (use of female providers, women-only settings, and women-only groups as often as desired). Results add to the growing literature documenting better health care experiences among more activated patients, and suggest that patient activation may play an important role in promoting engagement with mental health care.
Administration and Policy in Mental Health and Mental Health Services Research 04/2015; DOI:10.1007/s10488-015-0653-x · 3.44 Impact Factor
"This is an important finding, given the VA's substantial efforts to improve access to and quality of care for the growing population of women veterans. For example, women's health clinics and women's mental health specialty clinics are now available at many VA facilities (Oishi et al., 2011). It may be that these efforts have positively impacted perceptions of VA care and perceived fit for OEF/OIF female eveterans, although longitudinal work is needed to confirm these speculations. "
[Show abstract][Hide abstract] ABSTRACT: In the present study, the authors explored gender differences in attitudinal barriers to and facilitators of care for Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans and examined the relationship of those factors with VA mental health service use among female and male veterans with probable mental health conditions. Data were collected as part of a national cross-sectional survey of OEF/OIF veterans; the current sample was limited to participants with a probable diagnosis of posttraumatic stress disorder, depression, or alcohol abuse (N = 278). Although negligible gender differences were observed in attitudes about VA care and perceived fit in the VA setting, men reported slightly more negative beliefs about mental illness and mental health treatment than women. In addition, logistic regressions revealed different associations with VA mental health service use for women and men. For women only, positive perceptions of VA care were associated with increased likelihood of seeking mental health treatment. For men only, perceived similarity to other VA care users and negative beliefs about mental health treatment were associated with increased likelihood of service use, whereas negative beliefs about mental illness were associated with lower likelihood of service use. For both women and men, perceived entitlement to VA care was associated with increased likelihood of service use and negative beliefs about treatment-seeking were associated with a reduced likelihood of seeking mental health care in the past 6 months. Results support the need for tailored outreach to address unique barriers to mental health treatment for female and male OEF/OIF veterans. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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