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Veterans’ Perceptions of Behavioral Health Care in the Veterans Health Administration: A National Survey
Kimberly A. Hepner, Ph.D.; Susan M. Paddock, Ph.D.; Katherine E. Watkins, M.D., M.S.H.S.; Jacob Solomon, B.A.; Daniel M. Blonigen, Ph.D.; Harold Alan Pincus, M.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201200385
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Dr. Hepner, Dr. Paddock, Dr. Watkins, Mr. Solomon, and Dr. Pincus are with the RAND Corporation, Santa Monica, California (e-mail: hepner@rand.org). Dr. Pincus is also with the Columbia University College of Physicians and Surgeons and New York–Presbyterian Hospital, New York City. Dr. Blonigen is with the Center for Health Care Evaluation, U.S. Department of Veterans Affairs Palo Alto Health Care System, Palo Alto, California. Portions of this article were presented at the Mental Health Services Research conference, Washington, D.C., July 27–28, 2011.

Copyright © 2014 by the American Psychiatric Association

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Objective  This study provided national estimates of perceptions of behavioral health care services among patients of the Veterans Health Administration (VHA) with a diagnosis of bipolar I disorder, major depression, posttraumatic stress disorder, schizophrenia, or substance use disorder.

Methods  A stratified random sample of 6,190 patients completed telephone interviews from November 2008 through August 2009. Patients (N=5,185) who reported receiving VHA behavioral health care in the prior 12 months were asked about their need for housing and employment services, timeliness and recovery orientation of their care, satisfaction with care, and perceived improvement.

Results  Half of patients reported always receiving routine appointments as soon as requested, and 42% were highly satisfied with their VHA mental health care. Approximately 74% of patients reported being helped by the treatment they received, yet only 32% reported that their symptoms had improved. After controlling for covariates, the analyses showed that patients with a substance use disorder reported lower satisfaction with care and perceived their treatment to be less helpful compared with patients without a substance use disorder.

Conclusions  Although matched sample comparison data were not available, the results showed that overall patient perceptions of VHA mental health care were favorable, but there was significant room for improvement across all areas of assessment. A majority reported being helped by treatment, but few reported symptom improvement. Variations in perceptions among patients with different disorders suggest the potential importance of psychiatric diagnosis, particularly substance use disorder, in assessing patient perceptions of care.

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