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Preferences and Barriers to Care Following Psychiatric Hospitalization at Two Veterans Affairs Medical Centers: A Mixed Methods Study

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Abstract

Patient preferences and barriers to care may impact receipt of adequate mental health treatment following psychiatric hospitalization and could inform quality improvement initiatives. This study assessed preferences for a broad range of post-hospital services and barriers to counseling by surveying 291 patients and interviewing 25 patients who had recently been discharged from an inpatient psychiatric stay at one of the two Veterans Affairs Medical Centers. Individual counseling was the most frequently reported service that survey respondents preferred, but did not receive; whereas, open-ended survey responses and interviews also identified telephone follow-up “check-in” calls as a frequently preferred service. Difficulty with transportation was the most commonly cited barrier to counseling among survey respondents and in interviews; however, patients strongly preferred in-person counseling to telephone or internet-video alternatives. Increasing support from family and support from an individual Veteran peer were also perceived to be helpful in the majority of survey respondents.

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Conflicts of Interest

The authors have no conflicts of interest to report.

Funding Support

This work was undertaken as part of the Veterans Administration’s PACT Demonstration Laboratory initiative, supporting and evaluating VA’s transition to a patient-centered medical home. Funding for the PACT Demonstration Laboratory initiative is provided by the VA Office of Patient Care Services. Funding was also provided by the Department of Veterans Affairs Health Services Research and Development Service (HSR & D).

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Authors and Affiliations

  1. Department of Veterans Affairs, VA Center for Clinical Management Research, Ann Arbor, MI, USA

    Paul N. Pfeiffer MD, Nicholas Bowersox PhD, Jennifer Burgess MPH, Jane Forman ScD & Marcia Valenstein MD

  2. Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA

    Paul N. Pfeiffer MD, Nicholas Bowersox PhD & Marcia Valenstein MD

  3. Department of Veterans Affairs, VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA

    Denis Birgenheir PhD

  4. North Campus Research Complex, 2800 Plymouth Rd, Building 14, Ann Arbor, MI, 48109, USA

    Paul N. Pfeiffer MD

Authors
  1. Paul N. Pfeiffer MD
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  2. Nicholas Bowersox PhD
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  3. Denis Birgenheir PhD
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  4. Jennifer Burgess MPH
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  5. Jane Forman ScD
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  6. Marcia Valenstein MD
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Corresponding author

Correspondence to Paul N. Pfeiffer MD.

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Pfeiffer, P.N., Bowersox, N., Birgenheir, D. et al. Preferences and Barriers to Care Following Psychiatric Hospitalization at Two Veterans Affairs Medical Centers: A Mixed Methods Study. J Behav Health Serv Res 43, 88–103 (2016). https://doi.org/10.1007/s11414-015-9460-0

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  • DOI: https://doi.org/10.1007/s11414-015-9460-0

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