VA Community Mental Health Service Providers’ Utilization of and Attitudes Toward Telemental Health Care: The Gatekeeper's Perspective

Authors

  • John Paul Jameson PhD,

    1. Houston Center for Quality of Care & Utilization Studies, Houston, Texas. Dr. Jameson is now with the Department of Psychology, Appalachian State University, Boone, North Carolina
    2. Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
    3. Baylor College of Medicine, Houston, Texas
    4. South Central Mental Illness Research, Education, and Clinical Center, Houston, Texas
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  • Mary Sue Farmer PhD,

    1. South Central Mental Illness Research, Education, and Clinical Center, Houston, Texas
    2. South Central Mental Illness Research, Education, and Clinical Center, Little Rock, Arkansas
    3. Central Arkansas Veterans Healthcare System, Little Rock, Arkansas
    4. Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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  • Katharine J. Head MA,

    1. Houston Center for Quality of Care & Utilization Studies, Houston, Texas. Dr. Jameson is now with the Department of Psychology, Appalachian State University, Boone, North Carolina
    2. South Central Mental Illness Research, Education, and Clinical Center, Houston, Texas
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  • John Fortney PhD,

    1. South Central Mental Illness Research, Education, and Clinical Center, Houston, Texas
    2. South Central Mental Illness Research, Education, and Clinical Center, Little Rock, Arkansas
    3. Central Arkansas Veterans Healthcare System, Little Rock, Arkansas
    4. Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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  • Cayla R. Teal PhD

    1. Houston Center for Quality of Care & Utilization Studies, Houston, Texas. Dr. Jameson is now with the Department of Psychology, Appalachian State University, Boone, North Carolina
    2. Baylor College of Medicine, Houston, Texas
    3. South Central Mental Illness Research, Education, and Clinical Center, Houston, Texas
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  • This work was supported by the South Central Mental Illness Research, Education, and Clinical Center and the Houston Veterans Administration HSR&D Center of Excellence (HFP90–020). We thank Melinda A. Stanley, PhD, and Sonora Hudson, MA, for their helpful feedback on this manuscript. The views expressed in this article are those of the author(s) and do not necessarily represent the views of the Department of Veterans Affairs/Baylor College of Medicine.
    For further information, contact: John Paul Jameson, PhD, Department of Psychology, Appalachian State University, 222 Joyce Lawrence Lane, Boone, NC 28608; e-mail jamesonjp@appstate.edu.

Abstract

Context: Mental health (MH) providers in community-based outpatient clinics (CBOCs) are important stakeholders in the development of the Veterans Health Administration (VA) telemental health (TMH) system, but their perceptions of these technologies have not been systematically examined.

Purpose: The purpose of this study was to investigate the attitudes of CBOC providers about TMH services, current utilization of these technologies in their clinics, and sources of knowledge regarding TMH.

Method: The study employed a mixed-methods design to examine aspects of TMH in CBOCs located in a VA network in the south-central United States. Semistructured, on-site group interviews conducted with 86 CBOC MH providers were followed by in-depth phone surveys with an MH provider identified as a key informant at each of 36 CBOCs in the VA network.

Findings: The utilization of TMH services varied widely between CBOCs, and the scope of services provided typically focused on delivery of medication management, with little provision of psychological services. Further, several important barriers to expanded use of TMH were identified, including limited education and training and shortage of dedicated space for TMH encounters.

Conclusions: General attitudes toward TMH were positive, and most CBOC providers indicated that they would like to expand use of TMH in their clinics.

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