Associations Between VHA Clinical Resource Hubs Delivering Telemental Health Services

Introduction: The Veterans Health Administration (VHA) Clinical Resource Hubs (CRHs) provide telemental health (TMH) services to improve access for Veterans, but use varies greatly across clinics. Methods: A retrospective FY23 analysis examined all VHA outpatient mental health encounters. Clinics were categorized by CRH-MH use and level of CRH-MH penetration. Descriptive statistics, LASSO regression, and fixed-effects models identified key patient and clinic predictors. Results: Of 920 clinics, 218 used CRH-MH services. Clinics using CRH-MH services were larger, more likely to be VA medical centers, and had higher community care referrals. High-penetration sites were smaller, rural clinics with longer travel distances and lower community care use. Discussions: Large sites appear to use CRH-MH alongside existing resources to manage complex needs, while smaller rural sites rely heavily on CRH-MH to fill service gaps. Targeted strategies can strengthen CRH-MH integration, expand Veteran mental health access, and guide similar MH implementations in other health systems.