title: Preferences and Barriers to Care Following Psychiatric Hospitalization at Two Veterans Affairs Medical Centers: A Mixed Methods Study.
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.
authors.affiliation: Department of Veterans Affairs, VA Center for Clinical Management Research, Ann Arbor, MI, USA. ppfeiffe@umich.edu.|Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA. ppfeiffe@umich.edu.|North Campus Research Complex, 2800 Plymouth Rd, Building 14, Ann Arbor, MI, 48109, USA. ppfeiffe@umich.edu.
authors.forename: Paul N
authors.initials: PN
authors.lastname: Pfeiffer
authors.affiliation: Department of Veterans Affairs, VA Center for Clinical Management Research, Ann Arbor, MI, USA.|Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Bowersox
authors.affiliation: Department of Veterans Affairs, VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA.
authors.forename: Denis
authors.initials: D
authors.lastname: Birgenheir
authors.affiliation: Department of Veterans Affairs, VA Center for Clinical Management Research, Ann Arbor, MI, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Burgess
authors.affiliation: Department of Veterans Affairs, VA Center for Clinical Management Research, Ann Arbor, MI, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Forman
authors.affiliation: Department of Veterans Affairs, VA Center for Clinical Management Research, Ann Arbor, MI, USA.|Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA.
authors.forename: Marcia
authors.initials: M
authors.lastname: Valenstein
mesh_terms: D000328:Adult; D000368:Aged; D003376:Counseling; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D057240:Patient Preference; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans