Supporting Telemental Health for Rural Disabled Veterans: Bringing Rehabilitation Expertise to Rural Mental Health Providers

Abstract

<h3>Research Objectives</h3> To explore the unique challenges of using video telehealth for mental health care for rural veterans with complex disabilities for the purpose of developing resources for mental health providers serving rural veterans with complex disabilities. <h3>Design</h3> This is a sub-project of an ongoing study aiming to improve access to mental healthcare for veterans with disabilities. We collected insights from mental health providers during an online educational seminar, using discussion questions and chat transcripts to gather information on their experiences using telehealth. Thematic and content analysis were used to analyze responses. <h3>Setting</h3> Mental health service lines within VA Community-Based Outpatient Clinics (CBOC). <h3>Participants</h3> The online seminar consisted of mental health providers working in CBOCs, was held twice, and had 48 unique respondents across these sessions. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Participants discussed 1) considerations when recommending telehealth, 2) challenges encountered, and 3) resources needed to support initiating telehealth with a disabled veteran. <h3>Results</h3> Main themes that emerged include: Travel burden (e.g. high service utilization, travel distance, and transportation challenges) and access to tech (high-speed internet and video capable device) were most common considerations when recommending telehealth. Challenges reported included privacy concerns, limited familiarity with technology, and limited experience working with Veterans with complex disabilities. Desired resources included tailored training, educational materials, and systematic early intervention when a veteran becomes disabled. <h3>Conclusions</h3> Rural Veterans with disabilities face unique challenges to accessing mental health care. Video telehealth can bridge the gap, but Veterans with complex disabilities sometimes require more support in getting started. Because decisions to use telehealth are frequently provider driven, non-rehabilitation providers benefit from training and resources to facilitate working with Veterans who have complex disabilities. Further work is needed to address this topic. <h3>Author(s) Disclosures</h3> This work was supported by The Office of Rural Health and the Veterans Rural Health Resource Center in Salt Lake City.