Reaching Veterans with Cooccurring Mental Health Conditions Through the VA Whole Health System of Care

Objective: To examine the extent to which the Veterans Health Administration Whole Health System of Care (VA Whole Health) has reached Veterans with multiple mental health diagnoses. Methods: As part of a large-scale evaluation of VA Whole Health, Veterans were recruited from the 18 VA Whole Health pilot sites. In this cross-sectional evaluation, electronic health record data were used to examine the reach of core Whole Health educational and coaching activities and complementary and integrative health (CIH) use among Veterans across four mental health diagnostic groups: zero, one, two, or three diagnoses (i.e., anxiety, depression, post-traumatic stress disorder) in the past year. Logistic regression was used to determine the likelihood of core Whole Health and CIH use in each group, compared with each of the other diagnostic groups, adjusting for covariates. Results: Veterans (n = 9689; age = 64.1 years) were mostly men (86.8%) and White (75.3%). Veterans with more mental health diagnoses had higher odds of core Whole Health use, with adjusted odds ratios ranging from 1.19 (95% confidence interval [CI]: 1.02-1.38; two vs. one mental health diagnoses) to 2.36 (95% CI: 1.90-2.92; three vs. zero mental health diagnoses). Veterans with more mental health diagnoses also had higher odds of CIH use, with significant adjusted odds ratios ranging from 1.30 (95% CI: 1.05-1.62; three vs. two mental health diagnoses) to 2.29 (95% CI: 1.85-2.82; three vs. zero mental health diagnoses). Conclusions: VA Whole Health is designed to reach all Veterans, including those with complex health care needs, and this evaluation indicates promise that it is reaching this goal among Veterans with mental health concerns.