title: Review of American Indian veteran telemental health.
abstract: Rural American Indian veterans have unique healthcare needs and face numerous barriers to accessing healthcare services. Over the past decade, the Department of Veterans Affairs in conjunction with the University of Colorado Denver has turned to the promising field of telemental health to develop a series of videoconferencing-based clinics to reach this vulnerable population and improve mental healthcare services. The ongoing development, implementation, and expansion of these clinics have been assessed as part of a program improvement. The outcomes of these assessments have been documented in a series of published articles, controlled studies, program and case reports, and model descriptions. This article summarizes a decade of experience with the American Indian Telemental Health Clinics, the clinic model, and the literature arising from these clinics and presents lessons learned while establishing, maintaining, and evaluating these clinics. The ability to tailor the clinics to individual sites and cultures and to provide various services has been critical to the operation of the clinics. Culturally specific care through culturally knowledgeable providers, onsite tribal outreach workers, and collaboration with community services has proven essential in operating the clinics, as well as building rapport, trust, and engagement with the target patient population. It is hoped that the lessons learned and practices presented here can not only assist others working to improve the care for rural Native veterans but also serve as a model in the use of telemental health services for improving care and access to rural veteran and non-veteran populations.
authors.affiliation: Veterans Rural Health Resource Center-Western Region, Office of Rural Health, Department of Veterans Affairs, Salt Lake City, Utah, USA. jay.shore@ucdenver.edu
authors.forename: Jay
authors.initials: J
authors.lastname: Shore
authors.forename: L Jeanne
authors.initials: LJ
authors.lastname: Kaufmann
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Brooks
authors.forename: Byron
authors.initials: B
authors.lastname: Bair
authors.forename: Nancy
authors.initials: N
authors.lastname: Dailey
authors.forename: W J Buck
authors.initials: WJ
authors.lastname: Richardson
authors.forename: James
authors.initials: J
authors.lastname: Floyd
authors.forename: Jeff
authors.initials: J
authors.lastname: Lowe
authors.forename: Herbert
authors.initials: H
authors.lastname: Nagamoto
authors.forename: Robert
authors.initials: R
authors.lastname: Phares
authors.forename: Spero
authors.initials: S
authors.lastname: Manson
mesh_terms: D006301:Health Services Needs and Demand; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D008605:Mental Health Services / Q000458:organization & administration; D015397:Program Evaluation; D011570:Psychiatry / Q000458:organization & administration*; D017216:Telemedicine / Q000458:organization & administration*; D014481:United States; D014728:Veterans / Q000523:psychology*