Rural-Urban Disparities in Access to Interventional Psychiatry Treatments among VA Patients.
Rural mental health January 1, 2026 Brian Shiner, Vincent Dufort, Tayla Peltzman et al.
Rural and micropolitan veterans with major depressive disorder or posttraumatic stress disorder are less likely than urban veterans to receive interventional psychiatry treatments such as electroconvulsive therapy, repetitive transcranial magnetic stimulation, stellate ganglion block, deep brain stimulation, and ketamine. The largest disparities are for repetitive transcranial magnetic stimulation and ketamine, treatments that require repeated in-person visits. Few patients overall received any interventional psychiatry treatment from 2017 through 2024, and the numbers receiving magnetic seizure therapy, vagus nerve stimulation, MDMA-assisted psychotherapy, and psilocybin-assisted psychotherapy were too small to report in rural or micropolitan areas. These findings suggest that rural-urban disparities in access to mental health care may worsen as interventional psychiatry expands.