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2015 HSR&D/QUERI National Conference Abstract

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1144 — Strategies for Meeting Women Veterans' Mental Health Needs: The Potential of Tele-Mental Health

Zuchowski JL, HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy; Cordasco KM, HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy,David Geffen School of Medicine at UCLA; Young AS, HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy,David Geffen School of Medicine at UCLA; Oishi SM, HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy; Rose DE, HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy; Canelo I, HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy; Yano EM, HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy,UCLA Fielding School of Public Health; Hamilton AB, HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy,David Geffen School of Medicine at UCLA;

Objectives:
Telehealth services have the potential to increase women Veterans' access to Veteran-centered care, including mental health (MH) care that may be challenging to deliver due to geographic and other barriers. Our objective was to explore key stakeholder perceptions of the availability and potential of tele-mental health to address women Veterans' MH needs.

Methods:
We conducted semi-structured interviews with women's health key stakeholders (including clinic directors, primary care and MH leaders, women's health and MH providers, Women Veteran Program Managers, tele-health coordinators, and other staff members caring for women Veterans) at four geographically distinct VAMCs with well-established women's programs and one or two of their CBOCs. We asked about the main needs, including MH needs, of women Veterans and the availability of tele-health services to meet these needs. Interviews were transcribed, summarized, and coded in ATLAS.ti for content related to women Veterans' MH needs and tele-mental health services.

Results:
Key stakeholders (n = 43) viewed MH needs as highly prevalent among women Veterans. Across all four sites, tele-mental health was the most frequently described form of tele-health services, connecting patients at CBOCs with distant providers. Tele-mental health was perceived to increase access to providers who have specialized experience with particular needs, such as Military Sexual Trauma, and to reduce the burden of travel on women Veterans with caregiver responsibilities. Stakeholders expressed enthusiasm for tele-mental health's potential to improve access to care and desired to expand services, including offering virtual women's-only support groups. Some challenges noted were technical aspects of telehealth implementation (e.g., sufficient bandwidth, equipment, space). Some stakeholders voiced concerns about using tele-mental health in women with significant trauma histories who may be at risk of suicide.

Implications:
Tele-mental health was viewed as a promising and generally acceptable care modality for addressing the MH needs of women Veterans.

Impacts:
Given the promise of tele-mental health for meeting the needs of women Veterans, future work should address patient perspectives on and experiences with this type of care. More research is also necessary to determine if some sub-groups of women patients, such as those with significant trauma, are more or less appropriate to be served by tele-mental health.