title: Utilization of Mental Health Services by Veterans Living in Rural Areas.
abstract: There is concern that veterans living in rural areas may not be receiving the mental health (MH) treatment they need. This study uses recent national survey data to examine the utilization of MH treatment among military veterans with a MH condition living in rural areas, providing comparisons with estimates of veterans living in urban areas.
  
  
  
  Multivariable logistic regression is utilized to examine differences in MH service use by urban/rural residence, controlling for other factors. Rates of utilization of inpatient and outpatient treatment, psychotropic medication, any MH treatment, and perceived unmet need for MH care are examined.
  
  
  
  There were significant differences in MH treatment utilization among veterans by rural/urban residence. Multivariate estimates indicate that compared to veterans with a MH condition living in urban areas, veterans in rural areas had 70% lower odds of receiving any MH treatment. Veterans with a MH condition in rural areas have approximately 52% and 64% lower odds of receiving outpatient treatment and prescription medications, respectively, compared to those living in urban areas. Differences in perceived unmet need for mental health treatment were not statistically significant.
  
  
  
  While research indicates that recent efforts to improve MH service delivery have resulted in improved access to services, this study found that veterans' rates of MH treatment are lower in rural areas, compared to urban areas. Continued efforts to support the provision of behavioral health services to rural veterans are needed. Telemedicine, using rural providers to their maximum potential, and engagement with community stakeholder groups are promising approaches.
authors.affiliation: Center for Behavioral Health Statistics & Quality, Substance Abuse & Mental Health Services Administration, Rockville, Maryland.
authors.forename: Judith
authors.initials: J
authors.lastname: Teich
authors.affiliation: Center for Behavioral Health Statistics & Quality, Substance Abuse & Mental Health Services Administration, Rockville, Maryland.
authors.forename: Mir M
authors.initials: MM
authors.lastname: Ali
authors.affiliation: Center for Behavioral Health Statistics & Quality, Substance Abuse & Mental Health Services Administration, Rockville, Maryland.
authors.forename: Sean
authors.initials: S
authors.lastname: Lynch
authors.affiliation: Center for Behavioral Health Statistics & Quality, Substance Abuse & Mental Health Services Administration, Rockville, Maryland.
authors.forename: Ryan
authors.initials: R
authors.lastname: Mutter
mesh_terms: D000328:Adult; D005260:Female; D006297:Health Services Accessibility / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data*; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*
keywords: access to care; health disparities; mental health; rural veteran health; utilization of health services