Public Health Problems that Affect Certain Vulnerable Populations (Essay Sample)

Public Health Problems that Affect Certain Vulnerable Populations

Mental health conditions have a high prevalence among veterans compared to civilians. Different factors increase the risk of mental health illnesses in veterans including military service deployments, physical trauma and injury, and environmental exposures among other stressors. Although there have been advances in mental health testing and interventions, over half of the veterans with mental health disorders do not receive treatment (Ralstorn et al., 2019). This lack of engagement poses a problem in addressing mental health conditions within this population. This paper proposes an evidence-based intervention for service initiation and re-engagement in mental health treatment among veterans, specifically those in rural areas.
Evidence-Based Intervention
The Department of Veteran Affairs (VA), in a bid to improve care access to veterans in rural areas, established community-based clinics where veterans can receive mental health care. However, only about 20% of rural veterans with mental health conditions seek mental health services, and of those who do, only less than 10% complete the full course of treatment (Seal et al., 2021). This means that, even though access to care has been provided, care uptake and utilization are still a problem. A myriad of barriers has limited engagement of veterans in mental health treatment including geographical distance, lack of transport, cultural barriers like negative beliefs, mistrust of the healthcare system, stigma-related barriers, difficulty with scheduling an appointment, and negative beliefs about mental healthcare.
To address this issue, the proposed intervention is an outreach intervention using peer motivational coaching delivered via telephone calls or video calls. The main goal of this intervention is mental health care initiation, engagement, re-engagement for patients who disengaged, and retention in mental health care. This would improve service utilization and patient outcomes.
Evidence shows that outreach to veterans with serious mental illnesses who are disengaged from treatment can facilitate their return to care (Abraham et al., 2021). Peer outreach among veterans has been shown to improve engagement in mental health care engagement and reduce disengagement (Goetter et al., 2018). Although peer motivational coaching in Seal et al. (2021) did not show a significant difference in mental health treatment engagement, it had positive effects on quality-of-life indicators, improved mental health symptoms, and use of self-care strategies. Peer coaching would be effective for rural veterans because peers may have shared experiences, have a similar belief system, and may speak the same language. This strategy will encounter less resistance and can be effective in promoting change.
Implementation Plan
The intervention is highly collaborative. It involves identifying community-based outpatient clinics (CBOCs) that offer mental health services to veterans. Through these clinics, each provider will provide a list of names of veterans with mental illnesses who disengaged from receiving mental health services for at least one year. The providers will then contact the patients and facilitate appointments with health service providers. The next step would be to recruit volunteers for the peer coaching program. This will be done in collaboration with VA. The peer coaches will undergo a short training on the issues to discuss with the patients with mental health issues. Peer coaching will be 6–30-minute sessions that will include gathering data on barriers to seeking mental health care from patients during the sessions. Patients will be asked to choose between a telephone call or a video call session.
Stakeholders include the CBOCs, the VA, the community, family and caregivers, and interprofessional health providers. Potential costs include costs of training, telephone bills, internet, and production of training materials.
Potential Challenges
The potential challenges for implementation include unresponsive veterans who may need mental health care but may be unwilling to respond or commit to peer coaching. To address this, the implementation team will provide information materials to provide all clarification they need. The individual perception that veterans have on VA and mental health care, in general, has an impact on whether the veteran seeks mental healthcare or not. Apart from how veterans perceive mental health care, their perceptions of mental health care inform their mental health services utilization. The peer coaches will also be utilized to address any concerns they might have.