Associations Between VHA Clinical Resource Hubs Delivering Telemental Health Services.

Area of Science:

• Health Services Research
• Mental Health Services
• Telehealth Implementation

Background:

• Veterans Health Administration (VHA) Clinical Resource Hubs (CRHs) offer telemental health (TMH) to enhance Veteran access.
• Significant variability exists in CRH-TMH utilization across VHA clinics.

Purpose of the Study:

• To analyze factors influencing the adoption and penetration of CRH-TMH services within the VHA.
• To identify patient and clinic characteristics associated with CRH-TMH use.

Main Methods:

• Retrospective analysis of VHA outpatient mental health encounters in FY23.
• Clinic categorization based on CRH-TMH usage and penetration levels.
• Statistical modeling including LASSO regression and fixed-effects models.

Main Results:

• 218 out of 920 VHA clinics utilized CRH-TMH services.
• Clinics using CRH-TMH were larger, more often VA medical centers, with higher community care referrals.
• High-penetration sites were smaller, rural clinics with greater travel distances and less community care use.

Conclusions:

• Larger VHA sites integrate CRH-TMH with existing services for complex care.
• Smaller rural sites leverage CRH-TMH to address service gaps and improve access.
• Tailored strategies are needed to optimize CRH-TMH integration and expand mental health access for Veterans.