Stigmatization is one of the negative experiences that affect military veterans’ degree of seeking mental healthcare services. Military veterans are exposed to stressors that are contributing to the catastrophic symptoms. However, they seem to be underutilizing the mental healthcare services and disdain its availability. The prevalence of military workforce that live with stigma is very high, which is a significant factor that restricts them from looking for relevant healthcare services. In addition, many military veterans experience post-traumatic stress disorder (PTSD) after they return out of deadly missions or in their life in general.
Veteran health care ensures that American veterans get reliable admission to advanced mental health management to minimize the cases of self-annihilation amongst the veterans to ensure the quality of life after services. However, most counties in the US do not have practicing mental health practitioners, which limits the dimensions to delivering operative veteran-centric mental health facilities. This paper will review articles that show the quality and satisfaction of US military veterans with the department of veteran affairs mental health care system, focusing on the community-based care and rural area impacts.
A study was conducted to determine the satisfaction of veterans’ administration healthcare systems in the state of Michigan. The research employed personal interviews on the veterans through convenience sampling to identify and gather information on concerns and limitations that the veterans view as barriers to health care. Data were analyzed using Qualtrics to generate the summary of descriptive statistics of individual variables that were collected (Arnold, 2017). Arnold also used Pearson’s r product-moment correlation analysis to determine the variables strongly correlated to highlight if different distance groups had varied self-reported variables related to the perception regarding access to healthcare.
The study’s findings indicate that only five administration Medical Centers served over 600,000 veterans in Michigan. Besides, the medical centers are not evenly distributed in the entire state, with most of them being located in the southernmost part of Michigan. Many veterans pointed out that it was unnecessary to travel long distances to access these medical centers and receive the care they have been entitled to (Arnold, 2017). The research serves as a baseline to determine the perceptions of insufficiencies in healthcare provisions for the veterans in Michigan and their satisfaction with the healthcare they are supposed to get.
Additionally, another study is carried out to research the transgender Veterans’ gratification with medication and unrealized health requirements. The study was based on the background that transgender persons are overrepresented amongst the veterans (Lehavot et al., 2017). The study’s main objective was to examine the Veterans’ gratification with VA mental health caring, its occurrence of delayed care, and the links of such results. The study assessed 298 transgender veterans who resided in the US to the department to determine their gratification with VA medical and mental healthcare and self-testified stays. At the same time, they sought medication and mental health care.
The study used an online survey in collecting data, and campaigns were sent to the Veterans through Facebook ads. The members were requested if they underwent without medical care or if it was delayed. The study results showed that specific subgroups were not satisfied with medical care, although most were satisfied with VA healthcare (Lehavot et al., 2017). It is clear from the study that transgender veterans are a marginalized group with a few studies conducted on them. The online survey showed that the transgender group reported the highest satisfaction with their VA care despite the many social and economic disadvantages.
Moreover, the paper reviews a study that was carried out to examine the patient and facility factors that determine the satisfaction of inpatient mental health services. The study used random samples of veterans discharged from the department of VA inpatient units with primary diagnoses of mental health disorders. Questionnaires were mailed to the participants addressing their latest hospital experiences (Meterko, 1997). Data were analyzed using multiple regression analysis to determine the connection between patient and hospital features evaluated using 14 subscales.
The results indicated that 37 percent of the respondents mailed back to the questionnaires, and the majority of the respondents were satisfied with the better self-reports. However, it was clear that most of the respondents had lower satisfaction in extensive facilities and specialized in mental health. The study’s conclusion suggested that older patients and healthy people had the most excellent satisfaction with mental health care services (Meterko, 1997). It was also evident from this study that most of the VA are satisfied with the Mental health services that PTSD offers. The Veteran Military is constantly faced with trauma and mental issues that arise from the harrowing experiences that they encounter while at war.
Furthermore, research is carried to determine the function of psychiatric treatment with principal care. The study was based on the background that patients’ satisfaction was utilized as an indicator to determine the performance of VA in addressing the mental issues of Veterans. The study’s objectives were to evaluate the function of mental illness in satisfying the main care amenities in the VA division (Desai et al., 2005). A survey was conducted, and it was fused with organizational information to find out treatment and other features. The gratification evaluations were associated with mental diagnoses and athwart numerous elements of gratification with mental care.
The study outcomes indicated that after the features of the patients had been controlled, for instance, gender or age, there was a report of lower satisfaction of outpatient primary care. The reports on dissatisfaction were testified for the admission to care and general management of care. The study concluded that the VA system was responsible for access to specialty mental care. A good number of Veterans are less satisfied with most services offered (Desai et al. 2005). This dissatisfaction was the lower procedural eminence of care and poor interactive communication amongst healthcare practitioners and patients with mental health concerns.
Besides, another research evaluates the clinical and hypothetical basis for selecting the accelerated resolutions therapy to treat PTSD in VA. The study was based on the background that PSTSD is a chronic mental condition predominant between US service professionals and Veterans. The clinical protocol ART was concluded to discrete procedural stages, and a theoretical justification was determined to show the participants’ response (Kip & Diamond, 2018). The authors reviewed the actual treatment outcomes that were recorded in four ART studies. The ART protocol was then compared directly over some specific recommendation elements of therapy that relied on trauma amongst the VA.
The study results indicated a reduction in response over the rate of treatment over the four studies, and there was no care retort for the non-completers of the treatment process response (Kip & Diamond, 2018). The conclusion of the study indicated that ART protocol as therapeutic features that merge meticulously through the latest VA clinical exercise procedures the characteristics together with the confidence of the treatment protocol indicated that there were high satisfaction levels that offer a justification for the probable usage of ART as the first approach in PTSD care mode for the Veteran Military.
Also, a study is done to evaluate the treatment implementation and being exposed to elongated and intellectual dispensation therapy amongst the VA outpatient clinics. The main of the study was to utilize the vast amount of sample participants that followed the routine mental health routine care and comment on the number of eligible and referred veterans who had followed the prolonged exposure and dropped out of it (Kehle-Forbes et al., 2016). Data were retrieved from the medical reports of 427 veterans that were allocated to the team. They were categorized as being early dropouts and those who extended the admission to the different sessions of the study. It was found out almost one-quarter of the veterans ended up dropping before reached to the limit.
There were no significant predictors identified as the dropouts. Many prolonged exposed veterans were likely to drop out of the admission unless they had severe challenges when requiring further research to improve their conditions, for instance, engagement adherences. The study concluded that comprehensive considering the reasons for dropouts is required in developing the interventions to increase the admission process levels (Kehle-Forbes et al., 2016). The researchers recommend that future studies have to be carried out that comprise similar participants to provide information that will enhance the advancement of the explanatory representations of dropout, guiding the development of involvements.
Research has also been conducted to evaluate the National Implementation of Mental health observations in the VA Department. The department of veterans started to measure the mental health inventiveness to endorse measurement-based care in the mental health issues that should be tally with the national standards of care. The study phase was designed to achieve the positive goals of the department of the VA while reducing the actual barriers to the endorsement of the process levels (Resnick & Hoff, 2019). The first face also showed that different approached increased the level of reported results by the patient’s measures against the veterans that were still new to mental health care. The campaign was a success.
However, the results from the reports of the patients across the VA mental health were generally low. The study followed a small pilot initiative that accurately tested the approaches and suggestions that could meet the impact of the exposed timeline. The limitations of the study were that no financial and human capital. The implantation strategies comprised of the training resources (Resnick & Hoff, 2019). The clinicians typically use SA information to adjust the treatment regimen based on the conveyed progress of the reports of the department of the VA. The function is referred to as the fundamental reason as to why there was the collection of information.
As well, a group of researchers carried out research to determine the social determinants of mental health care schemes and the intensified community-based acre among veterans’ heath management. The study was based on the background that the public healthcare system had changed its main focuses from the ordinary asylums to the general hospitals responsible for mental health’s clinical and social causes (Bhalla et al., 2020). The study used the administrative data in comparing the veterans that completely the purposeful disabilities and the methods also addressed the engagement of the justice systems. Bivariate comparison of the demographics and polynomial logistic regression analysis were made to show the mental health prescription fillings. The study results showed that the patients who were basically in the outpatient facilities were receiving specialty and criminal justice services in remarkable homes.
The results were compared to those in clinics in the four communities and those using extensive mental health outpatient services. The study concluded that almost one-fifth of VA mental health patients received community-based services that powerfully address the main social determinants of health and mental health disorders (Bhalla et al., 2020). The effectiveness and cost-effectiveness and the VA participants implied that the trials were designed to be random. Therefore, the VA could access the national service systems that sorted the challenging aspects and remains that had to be done. However, the accessibility to such information was a complicated aspect.
Likewise, another research focused on evaluating the amount of use of the psychological resources amongst the soldiers returning but had concentrations on evaluating the barriers to access medical care. Additionally, the challenges in soldiers accessing mental health care supports were lower among the rural and the national mental healthcare service providers (Morgan et al. 2016). It was found out that a good number of police officers were actively seeking mental health assistance a few months after they had returned from war, and these findings were elevated when related to those of the previous data that the defense department had created.
The aspects that increased the occurrence of seeking such support comprise illness and depression amongst the veterans. The findings also indicate that almost all of the police officers reported PTSD and depressive disorders. The factors that enhanced the veterans’ need to seek mental health assistance comprise initial therapy and the psychological distress coupled with low well-being. The study’s limitations were that the data collection method generalized the findings, and this was not applying to some Veterans who reported similar concerns (Morgan et al., 2016). The study supports the assumption that shame is a hindrance for veterans seeking mental health care despite conducting the study on a narrow population of participants.
To sum up, another study was conducted to reveal that the Military veterans were not seeking healthcare while in their line of duty. The method adopted in the study was a mixed-method design that comprised up to 200 participants of soldiers that had a deployment to the Florida base (Michalopoulou et al., 2017). A quantitative question was used to allude to gender inequalities reported in mental health systems within the military. The study utilized the data collected from the responses of the patients who participated in the study. Post-Deployment Health Reassessments Programs (PDHRP) proved to be the best approach in keeping privacy and confidentiality and the security of data used in the study.
The study’s findings indicated that the usage of services pointedly reduces as mental health complication signs increased. There was a gender disparity in the data collected since the male gender proved to hide psychological health symptoms through the survey and were willing to show such signs through a phone interview. The female gender indicated varied views on the impediments to mental health care treatment (Michalopoulou et al., 2017). Some of the barriers to accessing mental health care are discomfort and lack of trust in the medical services.
According to most studies reviewed in this paper, most veterans are satisfied with the veterans’ administration healthcare systems. The reason behind this is that most Veterans experience PTSD after deadly missions or basically during their lifetime. However, the mental health medical centers for veterans are not evenly distributed across the county. This becomes a big challenge for several veterans who face other challenges like poverty in accessing mental health services. In addition, the veterans are generally encountered with trauma and mental disorders or substance abuse due to the problematic moments they go through while at war. Therefore, the community-based care and rural effects did not significantly impact the veterans’ satisfaction on accessing mental health care.
However, some studies indicate that cases of dissatisfaction were reported amongst some veterans who claimed to have difficulty accessing mental health care. The main reasons for the dissatisfaction were the reduced technical care and the poor interpersonal communication issues that exist between the healthcare service providers and the patients that have mental health disorders. Other factors that have been determined to cause dissatisfaction among veterans are shame because they fear tarnishing their reputation by getting involved with mental disorders. Therefore, the VA department should design initiatives to enhance veterans’ satisfaction in mental health since the prevalence of mental disorders among veterans is very high.
References
Arnold, D. (2017). Veterans’ Satisfaction with Veterans’ Administration Healthcare Systems. Web.
Bhalla, I. P., Stefanovics, E. A., & Rosenheck, R. A. (2020). Social Determinants of Mental Health Care Systems: Intensive Community-Based Care in The Veterans Health Administration. BMC Public Health, 20(1), 1-13. Web.
Desai, R., Stefanovics, E., & Rosenheck, R. (2005). The Role of Psychiatric Diagnosis in Satisfaction with Primary Care: Data from the Department of Veterans Affairs. Medical Care, 43(12),1208-1216. Web.
Kehle-Forbes, S. M., Meis, L. A., Spoont, M. R., & Polusny, M. A. (2016). Treatment Initiation and Dropout from Prolonged Exposure and Cognitive Processing Therapy in A VA Outpatient Clinic. Psychological Trauma: Theory, Research, Practice, and Policy, 8(1), 107. Web.
Kip, K. E., & Diamond, D. M. (2018). The Clinical, Empirical, And Theoretical Rationale for Selecting Accelerated Resolution Therapy to Treat Post-Traumatic Stress Disorder in VA and DOD Facilities. Military medicine, 183(9-10), e314-e321. Web.
Lehavot, K., Katon, J. G., Simpson, T. L., & Shipherd, J. C. (2017). Transgender Veterans’ Satisfaction with Care and Unmet Health Needs. Medical care, 55(Suppl 9 2), S90.
Meterko, M. (1997). Influence of Patient and Hospital Factors On Consumer Satisfaction With Inpatient Mental Health Treatment. System, 7, 8.
Michalopoulou, L. E., Welsh, J. A., Perkins, D. F., & Ormsby, L. (2017). Stigma and Mental Health Service Utilization in Military Personnel: A review of the literature. Military Behavioral Health, 5(1), 12-25. Web.
Morgan, J. K., Hourani, L., Lane, M. E., & Tueller, S. (2016). Help-Seeking Behaviors Among Active-Duty Military Personnel: Utilization of Chaplains and Other Mental Health Service Providers. Journal of Health Care Chaplaincy, 22(3), 102-117.
Resnick, S. G., & Hoff, R. A. (2019). Observations from the national implementation of Measurement-Based Care in Mental Health in the Department of Veterans Affairs. Psychological services. Web.