Timely care initiation is a priority within the Veterans Health Administration (VHA). Patients with serious mental illnesses (SMI) are a group that benefits from timely care initiation due to elevated risks of negative outcomes with delayed care. However, no evaluation has assessed whether VHA SMI patients disproportionately experience delays in mental health care initiation. VHA administrative care data were used to compare delays in mental health care initiation for VHA patients with and without SMI who had newly identified mental health needs. Analyses assessed rates of delayed initial mental health appointments within five settings (General Mental Health [GMH], Primary Care Mental Health Integration [PC-MHI], Post-Traumatic Stress Disorder [PTSD], Substance Use Disorder [SUD], and Psychosocial Rehabilitation clinics [PSR]). SMI patients were more likely to receive delayed initial appointments in three of five clinical settings (PTSD, SUD, PSR) and had significantly longer average wait times for an initial appointment when referred to the PTSD clinic for an initial appointment. Overall, SMI patients were equally as likely to receive delayed initial appointments. While VHA SMI patients were not more likely to experience delayed mental health care initiation overall, they were more likely to experience delays within three of the five treatment settings. Findings suggest that the majority of VHA SMI patients experience equivalent timeliness, though those with more complex needs, and particularly those with trauma-related care needs, may be more likely to experience treatment initiation delays. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

中文翻译：

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在有和没有严重精神疾病的退伍军人健康管理局患者中获得及时的精神保健治疗。

及时启动护理是退伍军人健康管理局 (VHA) 的优先事项。患有严重精神疾病 (SMI) 的患者是一组受益于及时护理的人群，因为延迟护理导致负面结果的风险增加。然而，没有评估评估 VHA SMI 患者是否在精神卫生保健开始时出现不成比例的延迟。VHA 行政护理数据用于比较新发现有心理健康需求的患有和未患有 SMI 的 VHA 患者的心理健康护理启动延迟。分析评估了五种环境（一般心理健康 [GMH]、初级保健心理健康整合 [PC-MHI]、创伤后应激障碍 [PTSD]、物质使用障碍 [SUD] 和心理社会康复）中的延迟初始心理健康预约率诊所 [PSR]）。SMI 患者更有可能在五个临床环境中的三个（PTSD、SUD、PSR）中接受延迟的初始预约，并且在转诊到 PTSD 诊所进行初始预约时，初始预约的平均等待时间显着延长。总体而言，SMI 患者接受延迟初始预约的可能性相同。虽然 VHA SMI 患者总体上不太可能经历延迟的精神保健开始，但他们更有可能在五种治疗环境中的三种中经历延迟。研究结果表明，大多数 VHA SMI 患者经历了同等的及时性，尽管那些有更复杂需求的患者，特别是那些有创伤相关护理需求的患者，可能更有可能经历治疗开始延迟。（PsycInfo 数据库记录 (c) 2022 APA，保留所有权利）。