Rural veterans face higher mental health barriers than urban veterans

An analysis published in The Journal of Rural Health found that among US Veterans with serious mental illness (SMI), rural Veterans were somewhat more likely to have co-occurring mental health conditions than urban Veterans but were less likely to receive SMI care.

Among 387,477 Veterans with SMI receiving care through the Veterans Health Administration in 2018–2022, 28% were rural. Compared with urban Veterans, rural Veterans were more likely to have mental health comorbidities including anxiety and posttraumatic stress disorder. Rural Veterans had a 38% lower odds of receiving SMI care, a 15% lower odds of having a video-to-home telehealth mental health visit, a 13% lower odds of having an outpatient mental health visit, and a 10% lower odds of receiving multidisciplinary care. Importantly, these rural-urban differences remained after accounting for key demographic and clinical characteristics.

Older age, white race, non-Hispanic or Latino ethnicity, being male, being widowed, and not having service connection were associated with a lower likelihood of later receiving mental health care.

The Veterans Health Administration offers some of the most comprehensive mental health services available for serious mental illness, including telehealth options designed to reach Veterans wherever they live. Our findings highlight an opportunity to ensure rural Veterans with SMI are aware of and able to access these services, by developing targeted outreach and support that addresses the barriers unique to this population."

Alexandra B. Caloudas, PhD, corresponding author, Michael E. DeBakey Veterans Affairs Medical Center, Houston