Association between intensive community mental health recovery service initiation and psychiatric symptoms among veterans.

Abstract

The Intensive Community Mental Health Recovery (ICMHR) services have been established by the Veterans Health Administration to provide veterans with high-quality mental health care. This study, for the first time, evaluates the association between ICMHR service initiation and change in psychiatric symptoms among veterans, to assess the effectiveness of these services. This retrospective observational study includes veterans who enrolled in ICMHR services during October 2018-September 2021, and had a Brief Psychiatric Rating Scale (BPRS) assessment at the time of ICMHR service enrollment (baseline), and at sixth and/or 12th month after enrollment. Multivariable random-effects linear regression was used to examine the change in BPRS scores over time during the first year after ICMHR service enrollment. Changes in the five clinically relevant BPRS domains were also examined. The study found a statistically significant decrease in BPRS scores during the sixth (adjusted change = -1.6; 95% CI [-2.2, -1.0]) and 12th month (adjusted change = -2.4; 95% CI [-3.0, -1.7]) follow-up after ICMHR service enrollment, as compared with the baseline score. The study also found that ICMHR service initiation was associated with considerable improvement in BPRS domains representing affect, activation, and negative and positive symptoms, but was not associated with changes to the domain representing resistance. These results suggest that ICMHR services were potentially effective in improving psychiatric symptoms, as measured by the BPRS scores, in veterans enrolled in these services. The services were not associated with improvement in all psychiatric symptoms, potentially indicating that additional services might be needed to manage symptoms that do not improve. (PsycInfo Database Record (c) 2025 APA, all rights reserved).