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Ready to Serve

Ready to Serve: Community-Based Provider Capacity to Deliver Culturally Competent, Quality Mental Health Care to Veterans and Their Families

Terri Tanielian
Coreen Farris
Caroline Epley
Carrie M. Farmer
Eric Robinson
Charles C. Engel
Michael William Robbins
Lisa H. Jaycox
Copyright Date: 2014
Published by: RAND Corporation
Pages: 32
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  • Book Info
    Ready to Serve
    Book Description:

    Ensuring that veterans and their families have access to high-quality mental health care is a national priority, and civilian providers are an increasingly important part of the workforce addressing veterans’ mental health needs. RAND conducted a survey of civilian mental health providers to gather information about their competency with military and veteran culture and their experience treating posttraumatic stress disorder and depression.

    eISBN: 978-0-8330-8942-7
    Subjects: Management & Organizational Behavior, Psychology, Health Sciences

Table of Contents

  1. Front Matter
    (pp. [i]-[ii])
    (pp. 1-1)

    Addressing the mental health needs of military service members, veterans, and their families is a national priority and the focus of many efforts at the federal, state, and local levels.¹ Over the past decade, several studies have documented the extent of the need for mental health treatment among this population, and billions of dollars have been invested to expand the capacity of the systems designed to support veterans and their families at multiple levels and across sectors.² The White House and Congress have been working directly with the Department of Defense (DoD) and and the Department of Veterans Affairs (VA)...

    (pp. 2-8)

    Improving mental health outcomes for veterans and their families requires bothaccess to careand receipt ofhigh-quality care.12The overall goal of this study was to understand the readiness of community-based providers to deliver high-quality mental health care to veterans and their families once they access such care. The IOM has definedhigh-quality careas care that has been demonstrated as effective (i.e., evidence-based), safe, patient-centered, timely, efficient, and equitable.13Using this definition as a reference point for our study, we conceptualize the readiness of providers to deliver veteran-friendly, high-quality mental health care as having two main components (see...

    (pp. 8-11)

    We recruited a total of 522 mental health care professionals to participate in the survey (Table 3). Respondents included roughly equal groups (by design) of psychiatrists (n=128), psychologists (n=127), social workers (n=132), and licensed counselors (n=135). The majority of participants across professions were female (60 percent) with some variation by profession (the majority of psychiatrists—77 percent—were male).28Respondents generally worked full time. In addition, participants reported seeing the majority of their patients (77 percent on average) in outpatient settings in the most recent typical work week, and smaller percentages of patients (17 percent on average) were seen in...

    (pp. 11-13)

    In this section, we report our findings on the military cultural competency of survey respondents. Cultural competency includes their knowledge and comfort related to military culture, self-reported proficiency working with veteran and military-affiliated patients, and prior training in military culture. We also report how individual and practice characteristics are associated with these aspects of military cultural competency. Understanding which factors are related to being more “veteran friendly” can help direct military cultural competency training to the set of providers most in need. We hypothesized that military cultural competency would be low among those providers who do not already treat veteran...

    (pp. 13-18)

    In this section, we explore respondents’ reported capability of delivering evidence-based care for PTSD and MDD. We report on whether participating providers were trained and inclined to implement guideline-concordant care for PTSD and MDD, and whether these providers reported using such care in their usual practice. The success of efforts to outsource mental health care for service members and veterans to civilian providers will depend, in part, on whether providers in the community are able and willing to deliver the high-quality care outlined in the VA/DoD CPGs for MDD and PTSD.32Based on previous reviews of provider practices,33we expected...

    (pp. 18-19)

    In this section, we explore the extent to which providers are “ready” to deliver culturally competent, high-quality care to veterans and their families. As we outlined in earlier sections, cultural competency can facilitate the development of therapeutic rapport and improve treatment receptivity, and the definition ofhigh-quality careincludes the use of treatments demonstrated to be effective (i.e., evidence-based). Thus, our concept of provider readiness in this study combines the domains of cultural competency and capacity to deliver high-quality care. We are particularly interested in understanding not only the proportion of providers that meet our definition of readiness, but also...

    (pp. 20-24)

    As veterans and their families seek care to address mental health concerns, they will be turning to providers working across multiple sectors. This study aimed to assess the readiness of those mental health providers working in community settings. While multiple factors may facilitate or inhibit a provider’s ability to deliver high-quality care—including the system-level incentives and treatment models employed within their settings—we focused on those related to the characteristics of the providers themselves. To do so, we examined the characteristics of a convenience-based sample of mental health professionals and assessed their knowledge, attitudes, and behaviors with respect to...

  9. Notes
    (pp. 25-28)
  10. About the Authors
    (pp. 29-29)
  11. About This Report
    (pp. 30-30)