Patterns and predictors of mental health service use among older veterans with alcohol use disorder who received a video-enabled tablet

Abstract

Objectives: Video-based telehealth may expand access to mental health services among older veterans with alcohol use disorder (AUD). We examined the modalities through which mental health services were rendered, and predictors of video visits before and after video-enabled tablet receipt from the Veterans Health Administration. Method: 11,210 veterans aged 60 or older with a diagnosis of AUD who received a tablet between 1 April 2020 and 25 October 2021 were identified. The electronic health record was used to characterized encounters by modality of mental health care delivery in the six months pre/post tablet receipt. Logistic regression examined predictors of a video visit for mental health. Results: Phone was the most common modality; however, the proportion of video encounters increased from 8.7% to 26.2% after tablet receipt. Individuals who were older, male, and had more physical health conditions, were less likely to have a video visit. Individuals who were married, resided in urban areas, had a history of housing instability, and had more mental health conditions, were more likely to have a video visit. Conclusion: Video-enabled tablets may help older adults with AUD overcome access barriers to mental health services, although targeted support for certain groups may be necessary.

Keywords:

• Alcohol use disorder
• mental health
• tablets
• veterans
• video-based telehealth

Acknowledgments

Views expressed in this article are those of the authors and not necessarily those for the Department of Veterans Affairs or the Federal Government.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This project was supported by a US Department of Veterans Affairs (VA) Quality Enhancement Research Initiative PEI 18-205 (Zulman, PI) and a Research Career Scientist Award (RCS 23-080) from VA Health Services Research and Development Service (Blonigen, PI). Views expressed are those of the authors and the contents do not represent the views of the US Department of Veterans Affairs or the United States Government. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.