{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T16:40:09Z","timestamp":1758904809044,"version":"3.44.0"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate whether Veterans infected with SARS\u2010CoV\u20102 have an elevated risk for needing mental health emergency care (MHEC) relative to uninfected comparators, as measured by emergency department or urgent care clinic utilization for a mental health diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources\/Extraction<\/jats:title><jats:p>Data from Veterans Health Administration (VHA), VHA\u2010paid, and Centers for Medicare &amp; Medicaid\u2010paid services were used to identify incident MHEC use within 1 year of infection for Veterans with a SARS\u2010CoV\u20102 infection and matched comparators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>This was a national, retrospective cohort study that leveraged a target trial emulation framework to examine long\u2010term outcomes of SARS\u2010CoV\u20102 infection among Veterans enrolled in VHA care. Uninfected comparators were matched based on month of infection, demographic, clinical, and health care utilization characteristics. We calculated cumulative incidence rates per 10,000 persons and utilized Cox regression models to estimate hazard ratios (HR) for MHEC up to one year post\u2010infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Principal Findings<\/jats:title><jats:p>The cohort included 207,968 Veterans with SARS\u2010CoV\u20102 and 1,036,944 comparators. The 365\u2010day incidence of MHEC use was greater among SARS\u2010CoV\u20102 patients than comparators (HR\u2009=\u20091.48; 95% CI: [1.44, 1.52]). Patients with SARS\u2010CoV\u20102 had a higher hazard for MHEC use than comparators in all timeframes analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>SARS\u2010CoV\u20102 infection was associated with increased MHEC use. Active care coordination with existing mental health treatment providers may help mitigate post\u2010infection mental health distress. Future research should explore specific contextual factors contributing to MHEC, such as gaps in continuity of care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1475-6773.14622","type":"journal-article","created":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T01:11:40Z","timestamp":1749172300000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Veteran Mental Health Emergency Care Utilization Following <scp>SARS<\/scp>\u2010<scp>CoV<\/scp>\u20102 Infection"],"prefix":"10.1111","volume":"60","author":[{"given":"Jason I.","family":"Chen","sequence":"first","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System (HCS)  Portland Oregon USA"},{"name":"Department of Psychiatry Oregon Health &amp; Science University (OHSU)  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meike","family":"Niederhausen","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System (HCS)  Portland Oregon USA"},{"name":"OHSU\u2010Portland State University School of Public Health, OHSU  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David P.","family":"Bui","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System (HCS)  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana J.","family":"Govier","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System (HCS)  Portland Oregon USA"},{"name":"OHSU\u2010Portland State University School of Public Health, OHSU  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mazhgan","family":"Rowneki","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System (HCS)  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Hickok","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System (HCS)  Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Troy A.","family":"Shahoumian","sequence":"additional","affiliation":[{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA HCS  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4020-8936","authenticated-orcid":false,"given":"Megan","family":"Shepherd\u2010Banigan","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine  Durham North Carolina USA"},{"name":"Population Health Informatics, Digital Health, Veterans Health Administration  Washington, DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Korpak","sequence":"additional","affiliation":[{"name":"Seattle Epidemiologic Research and Information Center VA Puget Sound  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Center of Innovation for Veteran\u2010Centered and Value\u2010Driven Care, VA Puget Sound HCS  Seattle Washington USA"},{"name":"Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound HCS  Seattle Washington USA"},{"name":"Department of Psychiatry and Behavioral Sciences University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan R.","family":"Teo","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System (HCS)  Portland Oregon USA"},{"name":"Department of Psychiatry Oregon Health &amp; 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Barrett","family":"Bowling","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine  Durham North Carolina USA"},{"name":"Department of Medicine Duke University  Durham North Carolina USA"},{"name":"Durham VA Geriatric Research Education and Clinical Center, Durham VA HCS  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward J.","family":"Boyko","sequence":"additional","affiliation":[{"name":"Seattle Epidemiologic Research and Information Center VA Puget Sound  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George N.","family":"Ioannou","sequence":"additional","affiliation":[{"name":"Center of Innovation for Veteran\u2010Centered and Value\u2010Driven Care, VA Puget Sound HCS  Seattle Washington USA"},{"name":"Division of Gastroenterology, Department of Medicine University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew L.","family":"Maciejewski","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine  Durham North Carolina USA"},{"name":"Population Health Informatics, Digital Health, Veterans Health Administration  Washington, DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann M.","family":"O'Hare","sequence":"additional","affiliation":[{"name":"Center of Innovation for Veteran\u2010Centered and Value\u2010Driven Care, VA Puget Sound HCS  Seattle Washington USA"},{"name":"Hospital and Specialty Medicine Service VA Puget Sound HCS  Seattle Washington USA"},{"name":"University of Washington  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth M.","family":"Viglianti","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research, VA Ann Arbor HCS  Ann Arbor Michigan USA"},{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theodore J.","family":"Iwashyna","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research, VA Ann Arbor HCS  Ann Arbor Michigan USA"},{"name":"Departments of Medicine and Health Policy and Management Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy S. 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