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MSN-FP6026: Population Health Policy Advocacy

Population Health Policy Advocacy: Mental Health Disorders among Veterans


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Letter to the Editor: Population Health Policy Advocacy

The Current State of the Quality of Care and Outcomes for Mental Health Disorders among Veterans in Rural Areas

Huge numbers of the U.S. military men and women frequently suffer from post-deployment depression, post-traumatic stress disorders and drug abuse related disorders after returning home from the warzones. Research has indicated that the ability to provide quality care for veterans experiencing mental disorders especially in rural areas is faced with significant challenges (Driscoll et al., 2018).  In the U.S., most military recruits are drawn from rural areas thus increasing the prevalence of mental health challenge in the rural setting. Contrary to this notation, veteran affair facilities are located in urban areas. When compared to their counterparts in urban and suburban areas, rural veterans rarely visit healthcare facilities, have limited access to mental health and specialty services, and seems to develop more psychological and physical health issues (Boscarino et al., 2020). Another underlying factor that has contributed to the increased rates of mental health problems among veterans in the rural setting is lack of training and experience among non-VA providers in these areas to effective manage PTSD and other disorders faced by veterans in rural setting (O’malley et al., 2020).  

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Why Mental Health Disorders among Veterans in Rural Areas Necessitates Health Policy Development and Advocacy

Recent research on the prevalence of mental health disorders among veterans indicate that older veterans experience similar mental health challenges as younger veterans, but the rate of PTSD differ based of the period the veteran was in service. PTSD rates differ between 10-31%, with the Vietnam-era veterans having high rates of PTSD rates. Despite high rates of PTSD among Vietnam-era veterans, they rarely seek VA mental health services (Driscoll et al., 2018).   This aspect is attributed to stigma, little knowledge, limited access to these services, and the normality of addressing mental health issues in primary care settings. Other factors such as lack of proper VA services in rural healthcare facilities, limited VA professionals in rural areas, inability for rural veterans to access VA healthcare services among other tenets necessitates the development of a health policy and advocacy program (Boscarino et al., 2020).

Why the Developed Policy Will Be Vital In Improving the Quality of Care and Outcomes Mental Health Disorders among Veterans in Rural Areas

Over the past decade, provision of mental health services for veterans in the rural environment has improved significantly, and various health issues previously documented for rural and urban veterans have been identified as clinically insignificant and uncommon to all veterans both in VA and non-VA environments. Moreover, introduction of “VA Choice” initiative has now expanded healthcare service alternatives for all veterans, thus enhancing provision of VA health services in rural settings (Driscoll et al., 2018). The VA Choice initiative enables veterans to receive VA based services from civilian healthcare facilities. This health policy and advocacy program was primarily designed to address the issue of VA delays in accessing medical care. Recently, the VA choice initiative was replaced by the “Mission Act” initiative which seems to have greater importance in the provision of care among future veterans (O’malley et al., 2020). The new program advocates for provision of enhanced family and caregiver support for all veterans injured during missions, but may also be expanded to cater for other veteran groups in the future.  

Advocate For Policy Development in Other Care Settings Mental Health Disorders among Veterans in Rural Areas

Mental health disorders has emerged to be among the leading cause of death and disability in the U.S. population representing 20% of all disorders. This implies that there is need to develop health policy and advocacy programs to address this problem in other care setting not only for veterans but also to elderly and young adults (O’malley et al., 2020).  For instance, in the United States, most veterans have access to private health insurance and are able to receive care even in non-VA facilities. Therefore it would be important to extend these service to the rural areas. Although there is an increase in service alternatives available to U.S. veterans, there limited definitive data sources related to service provision and veterans’ health status (Driscoll et al., 2018).  However, the knowledge gained from evaluating veteran’s mental health problems in non-VA facilities is essential to evaluate the quality of care and health policy and advocacy program needed by all veterans. 

How Interprofessional Aspects of the Developed Policy Will Support Efficient and Effective Achievement of Desired Outcomes for Veterans in Rural Areas

In order to effectively address issues related to mental health disorders among veterans in the rural areas, there is need to the health policy and advocacy programs identified above to be extended to not only soldiers at war but also the retired soldiers especially those in the rural areas (O’malley et al., 2020). Additionally, the U.S. government need to add more resources and VA healthcare facilities in the rural areas thus making it easier for veterans in the rural regions to access quality care at their convenience (Boscarino et al., 2020). There is also need to train more VA specialist both in rural and urban areas including caregivers and support specialist. Another interprofessional aspect that should be considered is to ensure both rural and urban veterans are insured medically and have equal access to VA services regardless of their location. 


Boscarino, J. J., Figley, C. R., Adams, R. E., Urosevich, T. G., Kirchner, H. L., & Boscarino, J. A. (2020). Mental health status in veterans residing in rural versus non-rural areas: results from the veterans’ health study. Military Medical Research7(1), 1-11.

Driscoll, M. A., Knobf, M. T., Higgins, D. M., Heapy, A., Lee, A., & Haskell, S. (2018). Patient experiences navigating chronic pain management in an integrated health care system: A qualitative investigation of women and men. Pain Medicine19(suppl_1), S19-S29.

O’malley, K. A., Vinson, L., Pless Kaiser, A., Sager, Z., & Hinrichs, K. (2020). Mental health and aging veterans: How the Veterans Health Administration meets the needs of aging veterans. Public Policy & Aging Report30(1), 19-23.

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