National Variations in VA Mental Health Care for Women Veterans
ABSTRACT 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.
- SourceAvailable from: Rachel Kimerling
[Show abstract] [Hide abstract]
- "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"
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
[Show abstract] [Hide abstract]
- "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. "
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).Psychological Services 11/2014; 12(1). DOI:10.1037/a0038269 · 1.08 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: This paper summarizes our view on intelligent cooperative control of human-machine systems. Taking recent advances of intelligent system integration in the field of mechatronics and successes using artificial neural networks, fuzzy logic and genetic algorithms, the field of intelligent control (IC) and intelligent human-machine systems is alive and exciting with a promising future. We focus on two aspects of modern intelligent control and robotic systems: (a) human-machine systems and (b) telerobotics using a broadband communication network infrastructure. In both areas we try to anticipate the future and discuss promising directions of research to approach the realization of more intelligent systemsEmerging Technologies and Factory Automation, 1996. EFTA '96. Proceedings., 1996 IEEE Conference on; 12/1996