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VA intensive mental health case management in urban and rural areas: veteran characteristics and service delivery.
Psychiatr Serv 2009; 60(7):914-21PS

Abstract

OBJECTIVE

The availability of mental health services in rural areas--particularly intensive services such as assertive community treatment (ACT)--has been of increasing concern and was the focus of this study. In recent decades the U.S. Department of Veterans Affairs (VA) has developed a national network of ACT-like programs called mental health intensive case management (MHICM), which have served veterans from diverse locations across the country, including urban and rural areas.

METHODS

This study used rural-urban commuting area codes and national VA administrative data to compare characteristics of veterans and patterns of MHICM service delivery among veterans with mental illness living in large urban, large rural, small rural, and isolated rural communities.

RESULTS

Among veterans enrolled in MHICM from FY 2000 to FY 2005 (N=5,221), 84% (N=4,373) resided in urban areas, 8% (N=421) in large cities, 6% (N=291) in small rural towns, and 3% (N=136) in isolated rural areas. MHICM participants who lived in rural areas had clinical problems broadly similar to those in urban areas, although more rural veterans were unemployed, disabled, received VA disability compensation, and had a payee or fiduciary. MHICM clients in smaller or isolated rural areas received slightly less frequent and less intensive contacts and less recovery-oriented services than those in large urban locations.

CONCLUSIONS

These data highlight the need for intensive case management services in rural areas and note some challenges in providing them at the intensity and frequency observed in urban areas where travel distances and times are shorter.

Authors+Show Affiliations

Veterans Integrated Services Network 1, Mental Illness Research, Education and Clinical Center, U.S. Department of Veterans Affairs, 950 Campbell Ave., West Haven, CT 06516, USA. somaia.mohamed@yale.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19564221

Citation

Mohamed, Somaia, et al. "VA Intensive Mental Health Case Management in Urban and Rural Areas: Veteran Characteristics and Service Delivery." Psychiatric Services (Washington, D.C.), vol. 60, no. 7, 2009, pp. 914-21.
Mohamed S, Neale M, Rosenheck RA. VA intensive mental health case management in urban and rural areas: veteran characteristics and service delivery. Psychiatr Serv. 2009;60(7):914-21.
Mohamed, S., Neale, M., & Rosenheck, R. A. (2009). VA intensive mental health case management in urban and rural areas: veteran characteristics and service delivery. Psychiatric Services (Washington, D.C.), 60(7), pp. 914-21. doi:10.1176/appi.ps.60.7.914.
Mohamed S, Neale M, Rosenheck RA. VA Intensive Mental Health Case Management in Urban and Rural Areas: Veteran Characteristics and Service Delivery. Psychiatr Serv. 2009;60(7):914-21. PubMed PMID: 19564221.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - VA intensive mental health case management in urban and rural areas: veteran characteristics and service delivery. AU - Mohamed,Somaia, AU - Neale,Michael, AU - Rosenheck,Robert A, PY - 2009/7/1/entrez PY - 2009/7/1/pubmed PY - 2009/9/24/medline SP - 914 EP - 21 JF - Psychiatric services (Washington, D.C.) JO - Psychiatr Serv VL - 60 IS - 7 N2 - OBJECTIVE: The availability of mental health services in rural areas--particularly intensive services such as assertive community treatment (ACT)--has been of increasing concern and was the focus of this study. In recent decades the U.S. Department of Veterans Affairs (VA) has developed a national network of ACT-like programs called mental health intensive case management (MHICM), which have served veterans from diverse locations across the country, including urban and rural areas. METHODS: This study used rural-urban commuting area codes and national VA administrative data to compare characteristics of veterans and patterns of MHICM service delivery among veterans with mental illness living in large urban, large rural, small rural, and isolated rural communities. RESULTS: Among veterans enrolled in MHICM from FY 2000 to FY 2005 (N=5,221), 84% (N=4,373) resided in urban areas, 8% (N=421) in large cities, 6% (N=291) in small rural towns, and 3% (N=136) in isolated rural areas. MHICM participants who lived in rural areas had clinical problems broadly similar to those in urban areas, although more rural veterans were unemployed, disabled, received VA disability compensation, and had a payee or fiduciary. MHICM clients in smaller or isolated rural areas received slightly less frequent and less intensive contacts and less recovery-oriented services than those in large urban locations. CONCLUSIONS: These data highlight the need for intensive case management services in rural areas and note some challenges in providing them at the intensity and frequency observed in urban areas where travel distances and times are shorter. SN - 1557-9700 UR - https://www.unboundmedicine.com/medline/citation/19564221/VA_intensive_mental_health_case_management_in_urban_and_rural_areas:_veteran_characteristics_and_service_delivery L2 - https://ps.psychiatryonline.org/doi/full/10.1176/ps.2009.60.7.914?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -