Perceived Barriers to Mental Health Care for American Indian and Hispanic Veterans: ReportS by 100 VA Staff

This study aimed to identify perceived barriers that might prevent American Indian (AI) and Hispanic American (HA) veterans from seeking mental health services at U.S. Veterans Administration Medical Centers (VAMCs), as reported by 100 VA mental-behavioral health staff members. A total of 100 volunteer mental-behavioral health workers were questioned, 50 from Albuquerque VAMC and 50 from Minneapolis VAMC. Participants responded to public announcements and e-mail invitations; facilitated, open-ended interviewing produced the barrier responses, which were then coded. Mental healthcare workers in both sites reported most perceived barriers as occurring in the VA system, among AI/HA veterans, and within themselves and/or their colleagues. Less commonly, they perceived barriers as occurring in the AI/HA families and communities. Mental healthcare workers at the Minneapolis VAMC reported more barriers than workers at the Albuquerque VAMC. A coding protocol derived from interviews among ethnic AI and HA staff members in the two VAMC's was applicable to mental health workers. Mental health workers agreed with AI and HA workers in perceiving most barriers as existing in the VA system, with family and community barriers being least often reported. Mental health workers perceived veterans as posing the second most common barrier category, followed by VA staff members.