Study Highlights Mental Health Services Important to Women Veterans
The implementation of patient-centered behavioral health services in primary care may improve the overall quality of VA mental healthcare, especially for under-represented populations. Mental and behavioral healthcare are especially important to the care of women in the VA healthcare system. Compared to men, women Veterans are more likely to suffer from a mental health condition, as well as comorbid chronic health conditions. Using data from the VA Women's Health Practice-Based Research Network (WH-PBRN), investigators in this study identified a subset of women Veteran primary care users (n=515) who were potential stakeholders for mental health services, and then quantified their priorities for these services. Study participants were surveyed and asked to rank their priorities for mental healthcare among a wide range of services, including treatment for: depression, PTSD, military sexual trauma (MST), eating disorders, smoking cessation, intimate partner violence (IPV), parenting support, family therapy, couples counseling, substance misuse, weight management, sleep problems, physical pain, and coping with chronic medical conditions. Investigators also examined the associations of demographic and clinical factors to the importance of designated women's services, in addition to relevant treatment preferences (i.e., co-location of mental health and primary care services, and tele-mental health modalities).
- Treatment for depression, pain management, coping with chronic conditions, sleep problems, weight management, and PTSD emerged as the top six mental healthcare priorities for women.
- The majority of women Veterans in this study (98%) selected at least one of these services as important, and 80% selected at least three of these six services as important.
- The majority of women who prioritized each of these six services reported that they had either used this type of service in the past year or were quite a bit or extremely likely to use the service within the next six months, ranging from 62% for weight management to 96% for chronic conditions.
- For all services, primary care co-location was strongly associated with higher ratings of importance for designated women's services.
- The initial four PBRN sites used for this study included only four VAMCs, with strong designated women's services. Prior positive experiences could have influenced the ratings of importance.
- This study focused on the perspectives of current VA users, and on the most frequently prioritized services. Less common gender-related issues (i.e., eating disorders) may be associated with particularly strong preferences for women's services.
- Findings suggest that women's primary care clinics, which are available at many VA healthcare facilities, are a strategic setting to enhance the implementation of women's health services through primary care-mental health integration.
This study was funded by HSR&D (SDR 10-012). Dr. Kimerling is part of HSR&D's Center for Innovation to Implementation: Fostering High Value Care located in Palo Alto, CA.
Kimerling R, Bastian L, Bean-Mayberry B, et al. Patient-Centered Mental Health Care for Women Veterans. Psychiatric Services. November 17, 2014;e-pub ahead of print.