Table 2.
Characteristics of Veterans using only VA or any community care for outpatient behavioral health, fiscal years 2016–2019
| Characteristic | Only VA use N=3,335,426 | Any community care use N=131,584 | Standardized mean difference | P-value | ||
|---|---|---|---|---|---|---|
| N | % | N | % | |||
| Individual medical conditions | ||||||
| Behavioral health condition group | 0.64 | <.001 | ||||
| Serious mental illness | 407,176 | 12.21 | 26,428 | 20.08 | ||
| Substance use disorder | 428,445 | 12.85 | 20,264 | 15.40 | ||
| Post-traumatic stress disorder | 671,222 | 20.12 | 45,058 | 34.24 | ||
| Personality disorders | 14,921 | 0.45 | 840 | 0.64 | ||
| Mood disorders | 555,706 | 16.66 | 20,669 | 15.71 | ||
| Anxiety disorders | 139,192 | 4.17 | 3,673 | 2.79 | ||
| Other behavioral health disorders | 60,756 | 1.82 | 1,462 | 1.11 | ||
| Non-behavioral health specific diagnoses* | 1,058,008 | 31.72 | 13,190 | 10.02 | ||
| Gagne physical health score (M±SD) | 0.95±2.01 | 0.54±1.39 | −0.24 | <.001 | ||
| Individual Characteristics | ||||||
| Age (M±SD) | 58.07±17.79 | 50.34±15.53 | −0.46 | <.001 | ||
| Sex | 0.27 | <.001 | ||||
| Male | 2,976,720 | 89.25 | 105,196 | 79.95 | ||
| Female | 358,694 | 10.75 | 25,481 | 19.36 | ||
| Missing | 12 | 0.00 | 907 | 0.69 | ||
| Race | 0.15 | <.001 | ||||
| American Indian or Alaska Native | 29,674 | 0.89 | 1,851 | 1.41 | ||
| Asian | 35,730 | 1.07 | 2,530 | 1.92 | ||
| Black or African American | 712,943 | 21.37 | 22,471 | 17.08 | ||
| Native Hawaiian or other Pacific Islander | 29,696 | 0.89 | 1,716 | 1.30 | ||
| White | 2,308,833 | 69.22 | 91,770 | 69.74 | ||
| Multiple races | 35,758 | 1.07 | 2,158 | 1.64 | ||
| Missing | 182,792 | 5.48 | 9,088 | 6.91 | ||
| Ethnicity | 0.12 | <.001 | ||||
| Hispanic | 231,318 | 6.94 | 12,502 | 9.5 | ||
| Non-Hispanic | 2,994,520 | 89.78 | 113,437 | 86.21 | ||
| Missing | 109,588 | 3.29 | 5,645 | 4.29 | ||
| Marital status | 0.09 | <.001 | ||||
| Married | 1,615,480 | 48.43 | 63,913 | 48.57 | ||
| Previously married | 1,096,465 | 32.87 | 39,429 | 29.96 | ||
| Never married | 566,983 | 17.00 | 23,308 | 17.71 | ||
| Missing | 56,498 | 1.69 | 4,934 | 3.75 | ||
| Homelessness | 0.15 | <.001 | ||||
| Homeless | 339,084 | 10.17 | 11,595 | 8.81 | ||
| Not homeless | 2,977,822 | 89.28 | 119,579 | 90.88 | ||
| Missing | 18,520 | 0.56 | 410 | 0.31 | ||
| Individual Access to the Healthcare System | ||||||
| Distance to VA primary care | 0.16 | <.001 | ||||
| > 40 miles | 165,552 | 4.96 | 11,532 | 8.76 | ||
| <= 40 miles | 3,164,488 | 94.88 | 119,757 | 91.01 | ||
| Missing | 5,386 | 0.16 | 295 | 0.22 | ||
| Rurality | 0.15 | <.001 | ||||
| Urban | 2,292,912 | 68.74 | 85,981 | 65.34 | ||
| Rural | 956,048 | 28.66 | 40,235 | 30.58 | ||
| Highly rural/Island | 35,102 | 1.05 | 1,917 | 1.46 | ||
| Missing | 51,364 | 1.54 | 3,451 | 2.62 | ||
| VA priority group assignment | 0.23 | <.001 | ||||
| 1–6 (high priority service – service connected disability or income) | 2,925,189 | 87.70 | 122,871 | 93.38 | ||
| 7–8 (above annual income threshold) | 359,024 | 10.76 | 7,195 | 5.47 | ||
| Missing | 51,213 | 1.54 | 1,518 | 1.15 | ||
| Health insurance status | 0.24 | <.001 | ||||
| No health insurance | 1,408,595 | 42.23 | 67,703 | 51.45 | ||
| Health insurance (private, Medicare, Medicaid) | 1,856,243 | 55.65 | 59,260 | 45.04 | ||
| Missing | 70,588 | 2.12 | 4,621 | 3.51 | ||
| County Characteristics | ||||||
| VA Medical Center or Community-Based Outpatient Clinic | 0.14 | <.001 | ||||
| Yes | 2,352,547 | 70.53 | 91,184 | 69.30 | ||
| No | 960,622 | 28.80 | 39,601 | 30.10 | ||
| Missing | 22,257 | 0.67 | 799 | 0.61 | ||
| Ratio of population to behavioral health providers in thousands (M±SD) | 1.00±1.71 | 0.84±1.29 | −0.10 | <.001 | ||
| Median income in thousands (M±SD) | 58.73±14,72 | 60.27±14.57 | 0.10 | <.001 | ||
| Unemployment rate (M±SD) | 4.47±1.24 | 4.45±1.34 | −0.01 | <.001 | ||
| Poverty rate (M±SD) | 15.11±4.89 | 14.88±4.58 | −0.05 | <.001 |
*
These are mostly diagnoses such as homelessness, counseling, insomnia, headache, etc., that describe services, circumstances, and symptoms that are frequently associated with a particular mental health diagnosis.