Veterans often avoid or drop out of mental health treatment, so new approaches are needed. A nature-based mindfulness intervention was tested against an indoor version for veterans with mental illness. Forty-one veterans from a Veterans Affairs health care center were randomly assigned to either a six-session outdoor or indoor group mindfulness program. More veterans completed the outdoor program than the indoor one, though average attendance did not differ. The outdoor group also showed greater reductions in posttraumatic stress disorder symptoms over time. Nature-based interventions may help reduce stigma and improve treatment completion rates for veterans.
Veterans who completed mindfulness-based interventions through the Veterans Affairs Health Care System reported seeking treatment for trauma, health concerns, depression, and anxiety, and they experienced benefits in depressive symptoms, anxiety, health concerns, and pain levels. More than half maintained a daily mindfulness practice 6 to 12 months after treatment. Different types of mindfulness interventions showed comparable long-term outcomes, but demographic variables correlated with different results. Presenting certain mindfulness skills early and building daily practice throughout treatment may help veterans access effective components and reduce dropout.
Among 98 veterans with psychiatric disorders enrolled in an 8-week mindfulness-based cognitive therapy (MBCT) class at a Veterans Administration Medical Center, average attendance was 4.87 of 8 sessions and only 16% attended all sessions. Greater numbers of pre-MBCT emergency department visits and psychiatric admissions predicted fewer sessions attended. Among the 27% of patients who had at least one psychiatric admission in the two years before or after the intervention, psychiatric admissions decreased significantly from pre- to post-MBCT; emergency department visits did not change significantly. The authors conclude that MBCT may be difficult to implement in outpatient VAMC settings due to high attrition and suggest screening for dropout risk, shorter interventions, or coupling MBCT with pleasurable activities.