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Usual Care for Rural Veterans With Posttraumatic Stress Disorder.

Kathleen M Grubbs1,2,3, John C Fortney4,5, Tim Kimbrell1,2,3

  • 1Center for Mental Health Outcomes Research, Health Services Research and Development, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas.

The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association
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PubMed
Summary
This summary is machine-generated.

Veterans with PTSD in community clinics receive medication management, but few access evidence-based psychotherapy. Expanding telehealth and group therapies may improve PTSD treatment access for rural veterans.

Keywords:
access to carehealth services researchmental healthposttraumatic stress disorderveterans

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Area of Science:

  • Mental Health Services Research
  • Health Services Research
  • Rural Health

Background:

  • Community-Based Outpatient Clinics (CBOCs) offer primary care and mental health services to rural veterans distant from Veterans Affairs (VA) hospitals.
  • Understanding usual care composition is crucial for enhancing access and engagement in evidence-based psychotherapy for posttraumatic stress disorder (PTSD).

Purpose of the Study:

  • To characterize the mental health treatment composition for veterans with PTSD receiving care in large and medium-sized CBOCs.
  • To identify potential strategies for improving access to and engagement in evidence-based psychotherapy for PTSD within the CBOC setting.

Main Methods:

  • 132 veterans with PTSD from 5 large and 6 medium CBOCs were enrolled in the usual care arm of a randomized control trial.
  • A 1-year chart review classified mental health encounters into 10 categories: 7 psychotherapy and 3 medication management.

Main Results:

  • 72% of veterans received medication management, with 30% via interactive video.
  • 58.3% received psychotherapy, but only 12.1% received evidence-based psychotherapy for PTSD.
  • Most psychotherapy was group-based; few encounters used interactive video.

Conclusions:

  • Veterans with PTSD in CBOCs predominantly receive medication management, with limited access to evidence-based psychotherapy.
  • Expanding interactive video for teletherapy and increasing group-based therapies could improve access to evidence-based PTSD treatments in CBOCs and home-based care.