Access to Mental Health Services at Veterans Affairs community-based outpatient clinics.

Access to care and treatment of mental disorders within the Veterans Health Administration (VHA) has seen dramatic changes in recent years. The VHA has been transformed from a hospital-based provider to one that relies on more outpatient care, although some are concerned this has compromised specialty services such as mental health care. The VHA is increasing the number of community-based outpatient clinics, which has improved access to primary care, and some are suggesting providing more mental health services at these clinics. The objective of this survey was to determine which clinics are currently providing mental health care and to identify clinics that provide little or no mental health care and their reasons for not doing so. A questionnaire was developed to answer these questions, and clinics were contacted by telephone to complete the survey. The results indicate that more clinics are providing basic mental health services than has been reported previously. The results also suggest that, before making changes in the delivery of mental health care within the VHA, a comprehensive study needs to be performed to identify current needs and establish a clear goal of how and where to provide quality mental health care for veterans.