Phase I development of an optimal integrated care pathway for veterans discharged from the armed forces

Abstract

Background: There is a lack of evidence to manage veterans with service-related mental health problems. This research aimed to develop an optimally effective, feasible, and acceptable integrated care pathway (ICP). Methods: A prototype ICP was developed through an initial modeling phase. Systematic reviews informed a portfolio of information for key stakeholders to discuss in a series of focus groups and semistructured interviews. They included 16 mental health professionals with expertise in the fields of mental health provision for military personnel, and 6 veterans with a history of mental illness. Data were analyzed through Inductive Thematic Analysis and used to inform the content, delivery, and guidance of an ICP. The prototype was piloted with 20 veterans in two pilot studies and refined on the basis of their quantitative and qualitative feedback. Results: The final ICP was agreed with additional guidance notes. It included three pathways covering referral, intervention, and management of veterans. Qualitative and quantitative results supported its efficacy in terms of reducing mental health symptoms and its acceptability to veterans. Conclusions: A specific veteran ICP shows promise as an effective and acceptable way of treating veterans with service related mental health problems.