Perceptions of behavioral health care quality for justice-involved veterans: a multi-jurisdictional analysis of Veterans Treatment Court team insights

Background: A key function of Veterans Treatment Courts (VTCs) is the facilitation of behavioral health care for criminal justice-involved veterans, and this care may occur in Veterans Health Administration (VHA) facilities and/or in the community. This study explores the perceived quality of care in these two settings based on interviews with 145 VTC team members from 20 court jurisdictions across the United States (US). Results: Team members’ observations were classified into six quality of care themes: qualified mental health professionals, timely access to services, empirically supported interventions, veteran-centered care, effective service delivery methods, and coordinated treatment. Within each theme, team members identified a series of issues and concerns. In some instances, concerns were noted across treatment settings and in other instances concerns were specific to VHA or community-based care. Conclusions: Several issues raised by VTC team members mirrored broader concerns within the US mental health system, but other issues were specific to criminal justice-involved veterans. VTC team members’ observations related to each theme were compared with existing research, revealing empirical support for the majority of identified concerns while also highlighting potential misconceptions about quality of care.