Women Veterans in primary care-mental health integration (PC-MHI) settings: A scoping literature review

Abstract: Women veterans (WV) present to Veterans Health Administration with mental health and medical treatment needs that differ from men and civilian women. Primary Care-Mental Health Integration (PC-MHI), which provides short-term, evidence-based mental health care, is often the first point of mental health assessment and intervention for veterans. Little research exists on gender-specific care, procedures, and impact for WV in PC-MHI, and many mental health providers feel ill-trained to address WV-specific concerns. This project aimed to identify the unique mental health necessities of WV within PC-MHI as compared with men, to support Veterans Health Administration Directive 1330.01 regarding providing gender-specific care, cultural competence among mental health providers, and under researched areas for further exploration to make a valuable contribution to the mission of PC-MHI regarding training, education, and implementation of gender-specific procedures. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, nine sources published between 2005 and 2023 were included. Results: were organized by gender comparisons, gender-specific care in PC-MHI, and mental health for WV. Preliminary sources indicate that WV present to PC-MHI with nuanced mental health concerns and utilize PC-MHI more than men. Subsequently, PC-MHI has promising potential to address gender-specific needs for WV. This review highlights the need for adaptation in mental health screening for WV in periods of increased mental health risk (e.g., postpartum) and across the lifespan. Findings emphasize the need for additional research on WV needs and gender-specific care in PC-MHI, as well as increased provider training, and establishment of evidence-based clinical guidelines and policies for WV in PC-MHI.