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Veterans were classified as rural\/highly rural (30.25%) or urban (69.75%) based on VHA Rural\u2010Urban Commuting Area codes. Rural\u2010urban differences were assessed for mental health disorders and service use across 4 VHA clinic types (i.e., integrated Primary Care\u2010Mental Health Clinic, General Mental Health Clinic, Posttraumatic Stress Disorder Clinical Team, Substance Use Disorder Clinic) using logistic regression models adjusted for age. Analysis of covariance models compared differences in utilization intensity among Veterans with at least 1 encounter in the designated clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Compared to urban Veterans with MST, rural Veterans with MST were more likely to be diagnosed with an anxiety disorder but less likely to be diagnosed with posttraumatic stress disorder, depression, bipolar disorder, alcohol use disorder, and other substance use disorder. As expected, rural Veterans with MST were less likely to receive individual and group psychotherapy services, regardless of the VHA clinic type, than their urban counterparts. Notably, rural Veterans remained in individual and group treatment longer than urban Veterans across nearly all clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Further investigation into challenges and opportunities to improve mental health care initiation among rural Veterans with MST is a critical next step in optimizing their well\u2010being and quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jrh.70013","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T22:47:13Z","timestamp":1741733233000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Rural\u2013urban differences in mental health and psychotherapy use among veterans with military sexual trauma: A retrospective cohort study"],"prefix":"10.1111","volume":"41","author":[{"given":"Derrecka M.","family":"Boykin","sequence":"first","affiliation":[{"name":"Houston VA HSR&amp;D Center for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey VA Medical Center  Houston Texas USA"},{"name":"Menninger Department of Psychiatry and Behavioral Sciences Baylor College of Medicine  Houston Texas USA"},{"name":"South Central Mental Illness Research Education and Clinical Center, Michael E. DeBakey VA Medical Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Haney","sequence":"additional","affiliation":[{"name":"Mental Health Care Line Michael E. DeBakey VA Medical Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber B.","family":"Amspoker","sequence":"additional","affiliation":[{"name":"Houston VA HSR&amp;D Center for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey VA Medical Center  Houston Texas USA"},{"name":"South Central Mental Illness Research Education and Clinical Center, Michael E. DeBakey VA Medical Center  Houston Texas USA"},{"name":"Department of Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Walder","sequence":"additional","affiliation":[{"name":"Houston VA HSR&amp;D Center for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey VA Medical Center  Houston Texas USA"},{"name":"Department of Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4201-4956","authenticated-orcid":false,"given":"Natalie","family":"Hundt","sequence":"additional","affiliation":[{"name":"Houston VA HSR&amp;D Center for Innovations in Quality, Effectiveness and Safety Michael E. 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