A survey of perceived barriers and attitudes toward mental health care among OEF/OIF veterans at VA outpatient mental health clinics
Abstract
OBJECTIVE: In an effort to improve our understanding of perceived treatment barriers among veterans of Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) relative to other era veterans, the current study examined veteran attitudes and beliefs about mental health treatment and treatment-seeking, and perceived patient and institution-level logistical barriers to care. METHOD: A survey was conducted among 434 Combat veterans seeking care in nine Veterans Affairs mental health care outpatient clinics. RESULTS: When compared to Vietnam and Gulf War veterans, OEF/OIF veterans were significantly more likely to endorse negative treatment attitudes as possible barriers to care. OEF/OIF veterans were also more likely than Vietnam veterans to endorse conflicting work demands as a potential barrier, although this was the only logistical barrier for which OEF/OIF veterans' responses differed significantly from those of veterans of other eras. Among OEF/OIF veterans, older veterans were more likely than younger veterans to endorse barriers related to cost and time commitments. CONCLUSIONS: These findings suggest an important role for outreach and engagement strategies that address attitudinal barriers to treatment utilization among veteran populations.
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Practical obstacles to mental health treatment, such as time constraints, distance from facilities, and competing priorities, are common among Veterans.
“Practical barriers, including time constraints, distance from a treatment facility, and competing priorities, are prevalent [9,10].”
From Development and evaluation of an 1-day Acceptance and Commitment Therapy workshop for Veterans with comorbid chronic pain, TBI, and psychological distress: Outcomes from a pilot study (2020) · cites this paper as [9]
The Results and Discussion (page unavailable in our copy) identify work conflicts and being too busy as perceived barriers, particularly among OEF/OIF veterans compared with Vietnam veterans. The paper assesses unreliable transportation but does not establish that distance from a facility is a barrier. Its sample is veterans already receiving VA outpatient mental health care, so it does not establish that all three barriers are prevalent among veterans generally. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAmong Veterans who begin mental health treatment, only a small fraction complete a full course of evidence-based therapy.
“Even among Veterans who start mental health treatment, only a small minority complete a recommended course of evidence-based therapy.”
From Development and evaluation of an 1-day Acceptance and Commitment Therapy workshop for Veterans with comorbid chronic pain, TBI, and psychological distress: Outcomes from a pilot study (2020) · cites this paper as [9]
The Introduction reports that fewer than 10% of OEF/OIF veterans diagnosed with PTSD or depression received the recommended amount of mental health treatment in their first several months of care. It also reports 68% dropout before completion at one VA PTSD clinic. These findings support concern about low treatment completion, but the first figure includes diagnosed veterans who may not have started treatment, and the clinic finding does not establish that only a small minority of veterans who start treatment complete a recommended course of evidence-based therapy. (LLM, conf=0.84)
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Additional file 1 of Mental health outcomes in communities exposed to Armed Conflict Experiences
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- Authors
- Garcia, H. A., Finley, E. P., Ketchum, N., Jakupcak, M., Dassori, A., & Reyes, S. C.
- Affiliations
- The University of Texas at San Antonio Health Science Center (US)
- Venue
- Military Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-03
- Volume
- 179
- Issue
- 3
- Pages
- 273-278
- ISSN
- 0026-4075 (ISSN-L)
- 1930-613X
- OpenAlex
- W2037810897
- Cited by
- 58
- References
- 33
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 1 · 2021: 8 · 2020: 7 · 2019: 7 · 2018: 4 · 2017: 7 · 2016: 4 · 2015: 4 · 2014: 2
- FWCI
- 8.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Military Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Georgia Clinical and Translational Science Alliance
- National Institutes of Health
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- OEF/OIF veterans, combat veterans, barriers to mental health care, treatment attitudes, treatment seeking, attitudinal barriers, logistics barriers, job demands, Vietnam War veterans, Gulf War veterans
- MeSH terms
- Ambulatory Care Facilities, Attitude to Health, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Male, Mental Health, Mental Health Services, Middle Aged, Outpatients, Retrospective Studies, Veterans, Afghan Campaign 2001-
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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