"Hit or Miss": Rural Veterans' Experiences Receiving Community Mental Health Care

Veteran use of Veteran Health Administration (VHA)-purchased community care (CC) for mental health has accelerated at a faster pace compared to both primary care and emergency services. Few studies have conducted an in-depth exploration of rural Veteran experience using community mental health. This paper focuses on the voices of rural Veterans, with the aim of exploring advantages and disadvantages for Veterans receiving mental health services through CC.

We conducted interviews with rural Veterans, using purposive sampling to identify Veterans through the Integrated Veteran Care Consolidated Data Sets who were enrolled in VHA medical centers in the southcentral United States, had received CC for mental health, and were living in a rural area. Interviews asked Veterans about their experience with receiving community mental health care. We used thematic analysis to organize quotes and present salient themes from interviews.

We interviewed 30 Veterans. We highlight four findings: (1) Most Veterans were pleased with the mental health care they received through the community. (2) Some Veterans reported instances of unprofessionalism and recognized a lack of military expertise among community providers. (3) Rural Veterans continue to face access barriers and noted limited availability of community mental health providers. (4) Difficulty with navigating multiple health systems impacted some rural Veterans' continuity of care.

While CC has improved access to mental health care for Veterans, there are concerns related to the quality of care and continuity gaps for rural Veterans.