Overcoming Barriers to Sustained Engagement in Mental Health Care: Perspectives of Rural Veterans and Providers

Fischer, Ellen P.; McSweeney, Jean C.; Wright, P. B.; Cheney, Ann M.; Curran, Geoffrey M.; Henderson, Kathy; Fortney, John C.

doi:10.1111/jrh.12203

Cited by 53 publications

(67 citation statements)

References 33 publications

(36 reference statements)

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“…One study showed that only a minor fraction of students who screened positive for a mental health problem actually sought help [ 39 ]. Although overcoming the stigma associated with mental health has been discussed at length, practical ways of mitigating this societal challenge remains a gap [ 40 , 41 ]. Our findings suggest that self-management is preferred by students and should be supported in future work.…”

Section: Discussionmentioning

confidence: 99%

Effects of COVID-19 on College Students’ Mental Health in the United States: Interview Survey Study

Son¹,

Hegde²,

Smith³

et al. 2020

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Background Student mental health in higher education has been an increasing concern. The COVID-19 pandemic situation has brought this vulnerable population into renewed focus. Objective Our study aims to conduct a timely assessment of the effects of the COVID-19 pandemic on the mental health of college students. Methods We conducted interview surveys with 195 students at a large public university in the United States to understand the effects of the pandemic on their mental health and well-being. The data were analyzed through quantitative and qualitative methods. Results Of the 195 students, 138 (71%) indicated increased stress and anxiety due to the COVID-19 outbreak. Multiple stressors were identified that contributed to the increased levels of stress, anxiety, and depressive thoughts among students. These included fear and worry about their own health and of their loved ones (177/195, 91% reported negative impacts of the pandemic), difficulty in concentrating (173/195, 89%), disruptions to sleeping patterns (168/195, 86%), decreased social interactions due to physical distancing (167/195, 86%), and increased concerns on academic performance (159/195, 82%). To cope with stress and anxiety, participants have sought support from others and helped themselves by adopting either negative or positive coping mechanisms. Conclusions Due to the long-lasting pandemic situation and onerous measures such as lockdown and stay-at-home orders, the COVID-19 pandemic brings negative impacts on higher education. The findings of our study highlight the urgent need to develop interventions and preventive strategies to address the mental health of college students.

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Section: Discussionmentioning

confidence: 99%

Effects of COVID-19 on College Students’ Mental Health in the United States: Interview Survey Study

Son¹,

Hegde²,

Smith³

et al. 2020

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“…Some veterans using healthcare services at the Department of Veterans Affairs (VA), face multiple potential barriers to VA healthcare services, particularly mental healthcare [ 1 , 2 ]. Previous research has examined the barriers faced by veterans obtaining needed VA mental healthcare services [ 3 – 9 ]. Limited attention has been paid to the influence of veterans’ experiences (e.g., prior military service, day-to-day struggles) and meaning systems on their perception of barriers to VA mental healthcare services.…”

Section: Introductionmentioning

confidence: 99%

Veteran-centered barriers to VA mental healthcare services use

Cheney

Koenig

Miller

et al. 2018

BMC Health Serv Res

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BackgroundSome veterans face multiple barriers to VA mental healthcare service use. However, there is limited understanding of how veterans’ experiences and meaning systems shape their perceptions of barriers to VA mental health service use. In 2015, a participatory, mixed-methods project was initiated to elicit veteran-centered barriers to using mental healthcare services among a diverse sample of US rural and urban veterans. We sought to identify veteran-centric barriers to mental healthcare to increase initial engagement and continuation with VA mental healthcare services.MethodsCultural Domain Analysis, incorporated in a mixed methods approach, generated a cognitive map of veterans’ barriers to care. The method involved: 1) free lists of barriers categorized through participant pile sorting; 2) multi-dimensional scaling and cluster analysis for item clusters in spatial dimensions; and 3) participant review, explanation, and interpretation for dimensions of the cultural domain. Item relations were synthesized within and across domain dimensions to contextualize mental health help-seeking behavior.ResultsParticipants determined five dimensions of barriers to VA mental healthcare services: concern about what others think; financial, personal, and physical obstacles; confidence in the VA healthcare system; navigating VA benefits and healthcare services; and privacy, security, and abuse of services.ConclusionsThese findings demonstrate the value of participatory methods in eliciting meaningful cultural insight into barriers of mental health utilization informed by military veteran culture. They also reinforce the importance of collaborations between the VA and Department of Defense to address the role of military institutional norms and stigmatizing attitudes in veterans’ mental health-seeking behaviors.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3346-9) contains supplementary material, which is available to authorized users.

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“…Barriers to obtain appropriate care can be grouped into the following categories: social, cultural, contextual, structural, clinical and procedural (Clement et al., 2012). Sociocultural barriers include differences in the manifestation of symptoms, the expression of emotional distress and different attributions about the causes and ways of dealing with mental health problems (Fischer et al., 2016; Valibhoy, Kaplan, & Szwarc, 2017). Some migrants may see self-help as the best way to deal with a mental disorder or they do not understand how physical or psychological health problems can be treated from the predominant cultural perspective (Hansen & Aranda, 2012; Kisa et al., 2016).…”

Section: Introductionmentioning

confidence: 99%

Barriers to care and psychopathology among Bolivian migrants living in São Paulo, Brazil

Bustamante

Cerqueira

Marzio

et al. 2019

Transcult Psychiatry

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The objective of this study was to investigate barriers to appropriate mental health care in a sample of Bolivian migrants living in São Paulo and to examine the association between barriers of care and the presence of symptoms of non-psychotic psychiatric disorders in this population. Considering that treatment usually reduces symptoms, it could be hypothesized that individuals reporting more barriers to care also will report more symptoms. The sample comprised 104 individuals born in Bolivia, with Bolivian nationality and living in São Paulo for at least 30 days prior to enrolling in the study, between 18 and 80 years of age and able to read and write in Spanish or Portuguese. The symptoms of mental disorders were assessed using the Self-Reporting Questionnaire (SRQ-20) and barriers to appropriate mental health care were evaluated using the Barriers to Assessing Care Evaluation (BACE). A multiple linear regression analysis was performed to determine the predictive effect of the BACE total score (independent variable) in the SRQ-20 score (dependent variable), including in the model, and the variables that were significantly correlated with the BACE total score or SRQ-20. Our results indicate that more than a half of the sample of Bolivian migrants living in Sao Paulo, Brazil, especially females, presented significant non-psychotic psychopathology. Individuals reporting more barriers to care, especially instrumental and attitudinal barriers, also have a higher risk of psychiatric symptoms, independently of sex, age and family income. Our results suggest that actions to increase availability of mental health services, especially culturally sensitive services, could reduce barriers to care and improve mental health among migrants.

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Overcoming Barriers to Sustained Engagement in Mental Health Care: Perspectives of Rural Veterans and Providers

Cited by 53 publications

References 33 publications

Effects of COVID-19 on College Students’ Mental Health in the United States: Interview Survey Study

Effects of COVID-19 on College Students’ Mental Health in the United States: Interview Survey Study

Veteran-centered barriers to VA mental healthcare services use

Barriers to care and psychopathology among Bolivian migrants living in São Paulo, Brazil

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