OBJECTIVES: Ensuring equitable access to mental health services is a national priority. The authors examined assertive community treatment (ACT) services initiation in the Veterans Affairs (VA) health system among program-eligible @entity1 . METHODS: The VA's National Psychosis Registry included 6,540 @entity1 who met program eligibility criteria ( @entity1032 diagnosis and prior hospitalization) in fiscal year (FY) 2003 (FY 2003) and had not received VA ACT services in FY 2001-FY 2003. Receipt of VA ACT services during FY 2004 was assessed with generalized estimating equations. Independent variables included age, gender, race and ethnicity, marital status, service-connected disability benefits, substance use disorder, @entity146 inpatient days in FY 2003, distance to the nearest facility with a VA ACT team, presence of an on-site team at the facility where the last VA @entity146 hospitalization occurred, and number of open slots with the nearest ACT team. RESULTS: A total of 452 of the eligible @entity1 (7%) received VA ACT services in FY 2004. In multivariate analyses, older age was associated with reduced odds of receiving ACT services (odds ratio [OR]=.92 per five years); being female (OR=1.86) and having @entity161 (OR=1.64) were positively associated with ACT services initiation. Individuals living farther from ACT sites were less likely to receive ACT services (OR=.95 per ten miles). The marginal effects of distance were most substantial in the first 30 miles and beyond 100 miles. CONCLUSIONS: Most @entity1 who were eligible for yet not already receiving VA ACT services went without these services in FY 2004. Geographic distance limited services initiation. Focused efforts are needed to enhance ACT services initiation and delivery, particularly for individuals in remote locations.

Initiation of assertive community treatment among veterans with serious XXXX : client and program factors.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity1032 :: ('MESH:D008607', 'Disease') :: ['mental illness'] @entity161 :: ('MESH:D012559', 'Disease') :: ['schizophrenia'] @entity146 :: ('MESH:D001523', 'Disease') :: ['psychiatric']
@entity1032 :: (MESH:D008607,Disease) :: ['mental illness']
