Perceived barriers to care among veterans health administration patients with posttraumatic stress disorder.

Abstract

VA Palo Alto Health Care System and Stanford UniversityDespite the availability of specialty posttraumatic stress disorder (PTSD) care withinDepartment of Veterans Affairs (VA) facilities, many VA patients with PTSD do notseek needed PTSD treatment. This study examined institutional and stigma-relatedbarriers to care among a large diverse group of Vietnam and Iraq/Afghanistan veteranswho had been diagnosed with PTSD by a VA provider. A total of 490 patients who hadnot received VA treatment for PTSD in the previous 2 years (31% response rate) wereasked about psychological symptoms and reasons for not using care. Stigma relatedbarriers (concerns about social consequences and discomfort with help-seeking) wererated as more salient (rated in the “slightly” to “moderately” problematic range) thaninstitutional factors (not “tting into” VA care, staff skill and sensitivity, and logisticbarriers; rated in the “not at all” to “slightly” problematic range). Regression analysesrevealed that younger age and White females were associated with higher ratings on nottting into VA health care, whereas non-White males were associated with higherratings on logistic barriers. PTSD symptoms were positively associated with perceivedbarriers to care, with the most consistent results observed for PTSD avoidance symp-toms. Magnitude of effects was generally small, suggesting the possibility that otherfactors not assessed in this study may also contribute to perceptions of barriers to care.Future research should attend to the effects of stigma, as well as institutional barriersto care, on VA mental health treatment seeking.Keywords: