Veteran-centered barriers to VA mental healthcare services use
Abstract Background Some veterans face multiple barriers to VA mental healthcare service use. However, there is limited understanding of how veterans’ experiences and meaning systems shape their perceptions of barriers to VA mental health service use. In 2015, a participatory, mixed-methods project...
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| Format: | Article |
| Language: | English |
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BMC
2018-07-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-018-3346-9 |
| _version_ | 1830413190362562560 |
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| author | Ann M. Cheney Christopher J. Koenig Christopher J. Miller Kara Zamora Patricia Wright Regina Stanley John Fortney James F. Burgess Jeffrey M. Pyne |
| author_facet | Ann M. Cheney Christopher J. Koenig Christopher J. Miller Kara Zamora Patricia Wright Regina Stanley John Fortney James F. Burgess Jeffrey M. Pyne |
| author_sort | Ann M. Cheney |
| collection | DOAJ |
| description | Abstract Background Some veterans face multiple barriers to VA mental healthcare service use. However, there is limited understanding of how veterans’ experiences and meaning systems shape their perceptions of barriers to VA mental health service use. In 2015, a participatory, mixed-methods project was initiated to elicit veteran-centered barriers to using mental healthcare services among a diverse sample of US rural and urban veterans. We sought to identify veteran-centric barriers to mental healthcare to increase initial engagement and continuation with VA mental healthcare services. Methods Cultural Domain Analysis, incorporated in a mixed methods approach, generated a cognitive map of veterans’ barriers to care. The method involved: 1) free lists of barriers categorized through participant pile sorting; 2) multi-dimensional scaling and cluster analysis for item clusters in spatial dimensions; and 3) participant review, explanation, and interpretation for dimensions of the cultural domain. Item relations were synthesized within and across domain dimensions to contextualize mental health help-seeking behavior. Results Participants determined five dimensions of barriers to VA mental healthcare services: concern about what others think; financial, personal, and physical obstacles; confidence in the VA healthcare system; navigating VA benefits and healthcare services; and privacy, security, and abuse of services. Conclusions These findings demonstrate the value of participatory methods in eliciting meaningful cultural insight into barriers of mental health utilization informed by military veteran culture. They also reinforce the importance of collaborations between the VA and Department of Defense to address the role of military institutional norms and stigmatizing attitudes in veterans’ mental health-seeking behaviors. |
| first_indexed | 2024-12-20T20:22:33Z |
| format | Article |
| id | doaj.art-4143e5a1b4e24fcbaa2cde8698137963 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-20T20:22:33Z |
| publishDate | 2018-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-4143e5a1b4e24fcbaa2cde86981379632022-12-21T19:27:32ZengBMCBMC Health Services Research1472-69632018-07-0118111410.1186/s12913-018-3346-9Veteran-centered barriers to VA mental healthcare services useAnn M. Cheney0Christopher J. Koenig1Christopher J. Miller2Kara Zamora3Patricia Wright4Regina Stanley5John Fortney6James F. Burgess7Jeffrey M. Pyne8Department of Social Medicine, Population, and Public Health, Center for Healthy Communities, School of Medicine, University of CaliforniaDepartment of Communication Studies, San Francisco State UniversityThe Center for Healthcare Organization and Implementation Research, VA Boston Healthcare SystemSan Francisco Veterans Affairs Health Care SystemSchool of Nursing, University of Arkansas for Medical SciencesHSR&D Center of Innovation, Central Arkansas VA Health Care SystemHealth Services Research and Development, Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care SystemThe Center for Healthcare Organization and Implementation Research, VA Boston Healthcare SystemHSR&D Center of Innovation, Central Arkansas VA Health Care SystemAbstract Background Some veterans face multiple barriers to VA mental healthcare service use. However, there is limited understanding of how veterans’ experiences and meaning systems shape their perceptions of barriers to VA mental health service use. In 2015, a participatory, mixed-methods project was initiated to elicit veteran-centered barriers to using mental healthcare services among a diverse sample of US rural and urban veterans. We sought to identify veteran-centric barriers to mental healthcare to increase initial engagement and continuation with VA mental healthcare services. Methods Cultural Domain Analysis, incorporated in a mixed methods approach, generated a cognitive map of veterans’ barriers to care. The method involved: 1) free lists of barriers categorized through participant pile sorting; 2) multi-dimensional scaling and cluster analysis for item clusters in spatial dimensions; and 3) participant review, explanation, and interpretation for dimensions of the cultural domain. Item relations were synthesized within and across domain dimensions to contextualize mental health help-seeking behavior. Results Participants determined five dimensions of barriers to VA mental healthcare services: concern about what others think; financial, personal, and physical obstacles; confidence in the VA healthcare system; navigating VA benefits and healthcare services; and privacy, security, and abuse of services. Conclusions These findings demonstrate the value of participatory methods in eliciting meaningful cultural insight into barriers of mental health utilization informed by military veteran culture. They also reinforce the importance of collaborations between the VA and Department of Defense to address the role of military institutional norms and stigmatizing attitudes in veterans’ mental health-seeking behaviors.http://link.springer.com/article/10.1186/s12913-018-3346-9Cultural domain analysisHealth care services useMental healthPatient-centered careQualitative researchVeterans |
| spellingShingle | Ann M. Cheney Christopher J. Koenig Christopher J. Miller Kara Zamora Patricia Wright Regina Stanley John Fortney James F. Burgess Jeffrey M. Pyne Veteran-centered barriers to VA mental healthcare services use BMC Health Services Research Cultural domain analysis Health care services use Mental health Patient-centered care Qualitative research Veterans |
| title | Veteran-centered barriers to VA mental healthcare services use |
| title_full | Veteran-centered barriers to VA mental healthcare services use |
| title_fullStr | Veteran-centered barriers to VA mental healthcare services use |
| title_full_unstemmed | Veteran-centered barriers to VA mental healthcare services use |
| title_short | Veteran-centered barriers to VA mental healthcare services use |
| title_sort | veteran centered barriers to va mental healthcare services use |
| topic | Cultural domain analysis Health care services use Mental health Patient-centered care Qualitative research Veterans |
| url | http://link.springer.com/article/10.1186/s12913-018-3346-9 |
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