Description, Development, and Philosophies of Mental Health Service Delivery for Female Veterans in the VA: A Qualitative Study

Abstract

Purpose National Veterans Health Administration (VA) organizational data suggested the presence of separate and formal mental health services for female veterans, prompting qualitative exploration of their structure and development. Methods Semistructured telephone interviews were conducted with a purposeful sample of 36 VA mental health administrators and providers from 26 VA Medical Centers and large community-based outpatient clinics that reported having separate women’s mental health clinics and/or designated women’s mental health providers in their outpatient mental health clinics. Main Findings VA facilities have implemented a spectrum of women’s mental health service delivery arrangements, including specialized mental health providers, co-located mental health providers in women’s health clinics, women-only mental health groups, and women’s mental health clinics. Most facilities had one or more “champions” developing such services, but some faced challenges in maintaining viability. Some respondents expressed concern about possible stigmatization associated with creating separate mental health services for female veterans. Conclusion Arrangements of VA mental health services for female veterans vary across facilities. This study identified a lack of consensus in the field regarding the need for and consequences of adapting existing programs specifically for the mental health needs of female veterans. Implementation of VA policy may require greater attention to frontline providers’ perspectives. Comparative impact studies of female veterans’ mental health service delivery arrangements are also needed.