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Perceived Barriers to Medical Care and Mental Health Care Among Veterans With Serious Mental Illness

Dr. Drapalski, Dr. Goldberg, and Dr. Dixon are affiliated with the Veterans Affairs (VA) Capitol Network (VISN 5) Mental Illness Research, Education and Clinical Center (MIRECC), 6A-157, VA Maryland Healthcare System, 10 North Greene St., Baltimore, MD 21201 (e-mail: amy.drapalski{at}va.gov). Dr. Milford was with VA Maryland Healthcare System, Baltimore, at the time of the study and is now with James A. Haley VA Medical Center, Tampa, Florida. Dr. Goldberg and Dr. Dixon are also with the Department of Psychiatry, University of Maryland School of Medicine, Baltimore, where Dr. Brown is affiliated with the Department of Epidemiology and Preventive Medicine and the Department of Psychiatry.

OBJECTIVES: This study examined perceived barriers to mental health care and medical care and the relationship between demographic and clinical characteristics and perceived barriers among veterans with serious mental illness. METHODS: Veterans diagnosed as having serious mental illnesses, hospitalized for psychiatric concerns, and at risk for treatment dropout (N=136) completed an interview as part of a larger study of a critical time intervention. RESULTS: Many participants perceived barriers to accessing mental health care (67%) and medical care (60%). Personal factors were cited most often as barriers; overall, however, personal barriers were more likely to be perceived to impede mental health care (56%) than medical care (43%). Psychiatric symptoms were associated with greater perceived barriers to mental health care and medical care. CONCLUSIONS: Veterans with serious mental illness at risk of treatment dropout perceived barriers to mental health care and medical services. Strategies to overcome barriers are needed and should target illness-related factors that may impede service use.

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August 2008: This Month's Highlights
Psychiatr Serv 2008 59: 835. [Full Text] [PDF]

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