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Asynchronous Electronic Screening for Unhealthy Alcohol Use Among Veterans in Primary Care: A Cluster Randomized Quality Improvement Trial.

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Veterans Affairs Clinical Resource Hub Improve Access to Mental Health Services for Rural Veterans.

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Area of Science:

  • Health Services Research
  • Mental Health Services
  • Telemedicine

Background:

  • The Department of Veterans Affairs (VA) implemented 18 Clinical Resource Hubs (CRHs) in 2019 to improve national access to virtual care.
  • CRHs were established to meet the VA's priority of enhancing healthcare accessibility through digital modalities.

Purpose of the Study:

  • To describe the volume and types of mental health care delivered by CRH teams.
  • To identify the professional backgrounds of staff within CRH Mental Health teams.
  • To analyze the utilization trends and patient demographics served by CRH Telemental Health (TMH) over the first three years of operation.

Main Methods:

  • A retrospective cohort study design was employed.
  • Data were sourced from national VA CRH mental health care utilization and staffing records for the initial three years.
  • Analysis focused on encounter types, diagnoses treated, and demographic characteristics of Veterans served.

Main Results:

  • Telemental Health (TMH) was the predominant mode of care delivery, accounting for 98.1% of all CRH Mental Health encounters.
  • The most frequently treated conditions included depression, post-traumatic stress disorder, and anxiety disorders.
  • Care delivery volume and the racial/ethnic diversity of Veterans served increased steadily over the study period. Psychologists comprised the largest staff group, followed by psychiatrists.

Conclusions:

  • Regional CRH Telemental Health (TMH) is a feasible and acceptable model for delivering mental health services.
  • CRH TMH effectively addresses common mental health diagnoses and shows increasing accessibility to traditionally underserved Veteran populations.
  • Future research should explore barriers to CRH TMH access for specific patient groups and evaluate its applicability to non-VA populations.