title: Veterans Health Administration mental health treatment settings of patients who report military sexual trauma.
abstract: The comprehensive Veterans Health Administration (VHA) policies on military sexual trauma (MST) include provider education and training at each VHA facility. No published data exist that indicate the settings in which VHA mental health patients with MST are treated. Such information could help set priorities for targeted MST-related education and training. The major aim of this article was to describe the VHA mental health outpatient settings in which patients with MST are most likely to be treated. National data from 79,903 female and 889,998 male veteran patients with at least one face-to-face outpatient mental health encounter at any VHA facility in fiscal year 2008 were analyzed. Among all veterans in VHA outpatient mental health care, 35.8% of women and 2.4% of men reported MST. The proportion of MST-positive patients ranged from 25.9% to 81.0% of women and from 1.5% to 56.1% of men across 9 major clinic setting categories. Proportions of women with MST were substantial across specialty MST clinics, specialty posttraumatic stress disorder clinics, psychosocial rehabilitation, and substance use disorder clinics, reflecting a wide range of settings. These settings should be prioritized for MST-related provider education and training. By contrast, male MST patients represented only a small proportion of patients in all clinics, with the exception of MST specialty clinics. Tailored conceptualizations of trauma-informed care are proposed for settings that encounter MST patients, even if these settings do not directly focus on the treatment of traumatic stress.
authors.affiliation: National Center for Posttraumatic Stress Disorder, VA Palo Alto Health Care System, Palo Alto, California 94025, USA.
authors.forename: Courtney
authors.initials: C
authors.lastname: Valdez
authors.forename: Rachel
authors.initials: R
authors.lastname: Kimerling
authors.forename: Jenny K
authors.initials: JK
authors.lastname: Hyun
authors.forename: Hanna F
authors.initials: HF
authors.lastname: Mark
authors.forename: Meghan
authors.initials: M
authors.lastname: Saweikis
authors.forename: Joanne
authors.initials: J
authors.lastname: Pavao
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007318:Inservice Training; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008605:Mental Health Services / Q000706:statistics & numerical data; D012050:Rehabilitation, Vocational / Q000706:statistics & numerical data; D012742:Sex Offenses / Q000517:prevention & control / Q000523:psychology* / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation; D014481:United States; D014493:United States Department of Veterans Affairs; D014600:Utilization Review; D014728:Veterans / Q000523:psychology*