JMIR Publications

ABSTRACT

Background:

Addiction treatment evolved quickly during the first year of the coronavirus pandemic in the United States, with changes likely increasing access to some forms of care (e.g., medications for opioid use disorder) and reducing access to others (e.g., inpatient treatments). Efforts to continue providing quality addiction treatment to Veterans may have benefitted from the Veteran’s Healthcare Administration’s existing telehealth infrastructure. Veterans’ experiences of care during this time are key to evaluating these efforts.

Objective:

Examine Veterans’ experiences of mental health and addiction treatment during the first year of the coronavirus pandemic.

Methods:

Cross-sectional self-report data were collected over three months starting in April 2021 using Qualtrics Panels. Participants were n=401 Veterans who (1) endorsed one or more substance use-related problems and (2) reported attending one or more mental health or addiction treatment appointments since April 1, 2020. The survey included standardized assessments of substance use risk severity and treatment satisfaction as well as study specific questions assessing past year care, including proportion of care received in person versus telehealth appointments and perceptions of treatment quality and access relative to before the pandemic.

Results:

Participants were 22% women, 67% white non-Hispanic, with an average age of 41.7 (SD=9.4). The majority were combat Veterans (85%) and Army was the most common branch represented (61%). Most (98%) endorsed items consistent with moderate to severe risk for one or more substance use disorders, with alcohol the most common (91%), and most (74%) meeting risk criteria for two or more substances. A fifth of participants (20%) reported their past year appointments were evenly split between in person and telehealth, while 43% received care primarily via telehealth, and 37% attended mostly in person. Average satisfaction with mental health and addiction treatment was comparable to previous addiction treatment studies (M=25.4; SD=4.1), and did not differ as a function of the proportion of care received via telehealth (F(2,398) = 2.77, p=.064). Most participants rated treatment as much better (27%), slightly better (38%) or the same (26%) and overall healthcare access as better (51%) or the same (30%) relative to before the pandemic. The distribution of satisfaction, quality, and access did not differ as a function of treatment modalities accessed in the past year (e.g., medications, inpatient).

Conclusions:

Veterans rated their treatment satisfaction, perceived quality of care, and overall healthcare access as largely better or the same relative to pre-pandemic care. These data should be interpreted in the context of the online administration and cross-sectional design. Nevertheless, findings align with recent work suggesting that Veterans with substance use disorders are particularly open to telehealth treatment options. These results also suggest that healthcare providers’ efforts to continue care during the first year of the coronavirus pandemic were well received.