title: Barriers to care for women veterans with posttraumatic stress disorder and depressive symptoms.
abstract: As the number of women veterans continues to rise, an issue of concern is whether those with mental health symptoms experience disproportionate barriers to care. The purpose of this study was to examine unmet medical needs and barriers to health care among women veterans who screened positive for lifetime posttraumatic stress disorder (PTSD), current depressive symptoms, both or neither. Using the National Survey of Women Veterans dataset (N = 3,593), we compared women veterans corresponding to these 4 groups on whether they had unmet medical needs in the past year, reasons for unmet needs, and barriers to using VA care for those not currently doing so. The majority of women veterans who screened positive for both PTSD and depressive symptoms had unmet medical care needs in the prior 12 months (59%), compared to 30% of women with PTSD symptoms only, 18% of those with depressive symptoms only, and 16% of women with neither set of symptoms. Among those reporting unmet medical needs (n = 840), those with both PTSD and depressive symptoms were more likely than the other groups to identify affordability as a reason for going without or delaying care. Among women veterans not using VA health care (n = 1,677), women with both PTSD and depressive symptoms were more likely to report not knowing if they were eligible for VA benefits and were less likely to have health insurance to cover care outside of the VA. These data highlight specific areas of vulnerability of women veterans with comorbid PTSD and depressive symptoms and identify areas of concern as VA and other health facilities work to ensure equitable access to care.
authors.affiliation: VA Puget Sound Health Care System, Seattle, Washington, and University of Washington, USA.
authors.forename: Keren
authors.initials: K
authors.lastname: Lehavot
authors.forename: Claudia
authors.initials: C
authors.lastname: Der-Martirosian
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Simpson
authors.forename: Anne G
authors.initials: AG
authors.lastname: Sadler
authors.forename: Donna L
authors.initials: DL
authors.lastname: Washington
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000191:economics / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000191:economics / Q000628:therapy*; D014481:United States; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*; D014930:Women / Q000523:psychology; D055815:Young Adult