Evaluating coordination and quality of care among veterans receiving posttraumatic stress disorder care in the community

C. Laurel Franklin; Amanda M. Raines; Chelsea R. Ennis; Joseph W. Boffa; Ansley M. Bender; Mara L. Ferrie; Taylor R. Nocera; Allison Dornbach‐Bender; Dustin A. Seidler; Karen D. Slaton; Leslie O'Malley; Mary O. Shapiro; Garry Laborde

doi:10.1002/jts.70012

journal article Sep 16, 2025

Evaluating coordination and quality of care among veterans receiving posttraumatic stress disorder care in the community

C. Laurel Franklin

Amanda M. Raines

Chelsea R. Ennis

Joseph W. Boffa

Ansley M. Bender Mara L. Ferrie Taylor R. Nocera Allison Dornbach‐Bender Dustin A. Seidler Karen D. Slaton Leslie O'Malley Mary O. Shapiro Garry Laborde

Journal of Traumatic Stress Vol. 39 No. 1 pp. 15-22 · Wiley

View at Publisher Save 10.1002/jts.70012

Abstract

Abstract

Despite an increase in the number of veterans receiving posttraumatic stress disorder (PTSD) care in the community, little work has examined the coordination and quality of care, particularly as it relates to U.S. Department of Veterans Affairs (VA) standards. To this end, the current project sought to document community care characteristics among veterans receiving outpatient psychotherapy services for PTSD. Specifically, the coordination of care and congruency with VA standards were examined. Data, which were collected over a 2‐year period from a VA hospital in the southeastern United States, included 123 PTSD community care consults across 103 unique veterans (
M
age
= 47.80 years,
SD
= 12.03; 72.4% Male; 50.4% Black). The majority of consults were new referrals for care (62.6%) due to the clinical service not being available or the average drive time to the nearest VA facility exceeding 30 min (77.2%). Regarding the coordination of care, records were not available for 27.6% of consults. Among veterans with treatment records, most were seen for an intake and psychotherapy (38.2%), followed by intake only and psychotherapy only. Formal diagnostic assessments were not documented in any intake records, with 21.2% of psychotherapy records documenting the use of a first‐line treatment for PTSD. Notably, most intake records (56.1%) failed to document any assessment of suicide risk, and no psychotherapy records indicated the loss of a PTSD diagnosis. The findings highlight gaps in the coordination and quality of care, particularly as it relates to VA standards, for veterans receiving PTSD care in the community.

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References

34

[1]

10.1176/appi.books.9780890425787

[2]

10.1007/978-3-030-97802-0_9

[3]

10.1037/ser0000143

[4]

10.1093/med-psych/9780190926939.001.0001

[5]

A Tipping Point for Measurement-Based Care

John C. Fortney, Jürgen Unützer, Glenda Wrenn et al.

Psychiatric Services 10.1176/appi.ps.201500439

[6]

10.1016/j.janxdis.2015.02.003

[7]

10.3389/fpsyg.2020.01998

[8]

10.1016/j.jpsychires.2021.01.039

[9]

10.1037/a0033888

[10]

Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018. (2018).115 U.S.C. Public Law 115‐182. (2018).

[11]

10.1007/s11606‐019‐04972‐1

[12]

10.1002/jts.21690

[13]

10.1016/j.janxdis.2010.11.010

[14]

10.1016/j.cpr.2010.04.007

[15]

10.1007/s10608‐023‐10429‐x

[16]

Resick P. A. (2024)

[17]

10.1016/j.janxdis.2023.102675

[18]

10.1001/jamanetworkopen.2024.52144

[19]

10.1080/03007995.2021.1978417

[20]

10.1001/jama.297.8.820

[21]

10.1007/978-3-319-46138-0_13

[22]

10.1037/0000441-000

[23]

Tanielian T. (2014)

[24]

Risk Factors for Homelessness Among US Veterans

J. Tsai, R. A. Rosenheck

Epidemiologic Reviews 10.1093/epirev/mxu004

[25]

U.S. Department of Veterans Affairs. (2023).Treatment for veterans with posttraumatic stress disorder[VHA Directive 1160.03].https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=11499

[26]

U.S. Department of Veterans Affairs. (2024).National veteran suicide prevention annual report.https://www.mentalhealth.va.gov/docs/data‐sheets/2024/2024‐Annual‐Report‐Part‐2‐of‐2_508.pdf

[27]

U.S. Department of Veterans Affairs/U.S. Department of Defense. (2023).VA/DoD clinical practice guideline for management of posttraumatic stress disorder and acute stress disorder.https://www.healthquality.va.gov/guidelines/mh/ptsd/

[28]

Experiences With VA-Purchased Community Care for US Veterans With Mental Health Conditions

Megan E. Vanneman, Eric T. Roberts, Yaming Li et al.

JAMA Network Open 10.1001/jamanetworkopen.2025.11548

[29]

Differences Between VHA-Delivered and VHA-Purchased Behavioral Health Care in Service and Patient Characteristics

Megan E. Vanneman, Amy K. Rosen, Todd H. Wagner et al.

Psychiatric Services 10.1176/appi.ps.202100730

[30]

10.1377/hlthaff.2019.01375

[31]

Veterans Access Choice and Accountability Act of 2014 113 U.S.C. Public Law 113‐146. (2014).

[32]

Weathers F. W. Blake D. D. Schnurr P. P. Kaloupek D. G. Marx B. P. &Keane T. M.(2013).The Clinician‐Administered PTSD Scale for DSM‐5 (CAPS‐5).https://www.ptsd.va.gov/professional/assessment/adult‐int/caps.asp

[33]

Weathers F. W. Litz B. T. Keane T. M. Palmier P. A. Marx B. P. &Schnurr P. P.(2013).The PTSD Checklist for DSM‐5 (PCL‐5).https://www.ptsd.va.gov/professional/assessment/adult‐sr/ptsd‐checklist.asp

[34]

10.1007/s11606‐024‐08787‐7

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Details

Published: Sep 16, 2025
Vol/Issue: 39(1)
Pages: 15-22
License: View

Authors

C

C. Laurel Franklin

Southeast Louisiana Veterans Health Care System New Orleans Louisiana USA; South Central Mental Illness Research Education and Clinical Center (MIRECC) New Orleans Louisiana USA; Department of Psychiatry and Behavioral Sciences Tulane University School of Medicine New Orleans Louisiana USA

A

Amanda M. Raines

Southeast Louisiana Veterans Health Care System New Orleans Louisiana USA; South Central Mental Illness Research Education and Clinical Center (MIRECC) New Orleans Louisiana USA; School of Medicine Louisiana State University New Orleans Louisiana USA

C

Chelsea R. Ennis

Southeast Louisiana Veterans Health Care System New Orleans Louisiana USA; South Central Mental Illness Research Education and Clinical Center (MIRECC) New Orleans Louisiana USA; Department of Psychiatry and Behavioral Sciences Tulane University School of Medicine New Orleans Louisiana USA

J

Joseph W. Boffa

Southeast Louisiana Veterans Health Care System New Orleans Louisiana USA; South Central Mental Illness Research Education and Clinical Center (MIRECC) New Orleans Louisiana USA; School of Medicine Louisiana State University New Orleans Louisiana USA

A

Ansley M. Bender