Facilitators and Barriers to Seeking Mental Health Care Among Primary Care Veterans With Posttraumatic Stress Disorder

• Published in: Journal of traumatic stress 2018-10, Vol.31 (5), p.742-752
• Main Authors: Possemato, Kyle, Wray, Laura O., Johnson, Emily, Webster, Brad, Beehler, Gregory P.
• Format: Article
• Language: English
• Subjects: Mental health; Mental health care; Post traumatic stress disorder; Primary care; Stress
• ISSN: 0894-9867; 1573-6598
• DOI: 10.1002/jts.22327

Although posttraumatic stress disorder (PTSD) is common in primary care patients, many do not seek mental health treatment. Existing research on barriers and facilitators to receiving PTSD treatment are not specific to primary care patients. In this study, we sought to understand the psychosocial concerns, treatment barriers, and treatment facilitators among non‐treatment‐seeking primary care veterans with PTSD who reside in both rural and urban settings. Using a concurrent triangulation design, we collected qualitative focus group and quantitative self‐report data concurrently, analyzed them separately, and merged the results for interpretation. In total, 27 veteran primary care patients with PTSD participated in 1 of 4 focus groups. A modified conventional content analysis approach was used. Team‐based coding began with three broad primary codes (psychosocial concerns, barriers, and facilitators) and subcodes were allowed to emerge from the data. Self‐report measures were used to collect clinical characteristics and barriers to care. The results expanded upon existing models of PTSD treatment initiation by (a) specifying treatment preferences, such as patient‐centered care, peer support services, and open access scheduling, and (b) presenting concerns, such as anger and core symptoms of PTSD. Results also indicated that a commonly used quantitative barriers measure may offer an incomplete picture of why veterans do not seek treatment as it does not assess how past negative treatment experiences may affect utilization. Strategies to help veterans overcome barriers to care may benefit from a focus on negative treatment‐seeking beliefs and tailoring based on a veteran's rural or urban status. Resumen Spanish s by Asociación Chilena de Estrés Traumático (ACET) Facilitadores y barreras para la búsqueda de atención de salud mental entre veteranos de atención primaria con TEPT FACILITADORES Y BARRERAS PARA BÚSQUEDA DE ATENCIÓN EN TEPT El trastorno de estrés postraumático (TEPT) es común en pacientes de atención primaria, sin embargo no buscan un tratamiento de salud mental. Las investigaciones existentes acerca de barreras y facilitadores para recibir tratamiento en TEPT no son específicas en pacientes de atención primaria. En este estudio, hemos buscado entender las preocupaciones psicosociales, barreras y facilitadores de tratamiento entre veteranos que no buscan tratamiento de atención primaria en TEPT que residen en ambos contextos urbano y rural. Utilizand