Serving it Forward

Serving it Forward

Grand Island VA leaves no rural veteran behind

It’s quite a paradox. American veterans — who have put everything on the line in service to our country, and whose mental and physical health conditions are often a result of that sacrifice — are some of the most medically underserved men and women in the nation. 

Grand Island VA health care leaders are all too familiar with this standard. Fortunately, that doesn’t stop them from combatting it every day. 

“I know the access issues for rural populations,” said Dr. Krista Krebs, a psychologist at Grand Island VA. “Veterans generally come from rural areas more than urban. And they tend to go back home when they’re done with their service.” 

Almost a quarter of all U.S. veterans — presently, 4.4 million men and women — reside in rural communities following active duty military careers. Over half are enrolled in Veterans Affairs (VA) health care programs, and 58% of those enrolled suffer from at least one service-related injury or health condition. 

Dr. Kathleen Amyot is a medical doctor and serves as the Grand Island VA’s deputy chief of staff. According to Dr. Amyot, veterans tend to require more complex medical care plans. 

“In general, veterans are a little bit different than the average patient based on their experiences, and based on exposures potentially that they’ve had during their military service,” she said. 

Veterans are at a higher risk than the average civilian for developing drug and alcohol addictions, dying from opioid overdose and dying by suicide. 

Data published by the American Psychological Association and the U.S. Department of Veterans Affairs reports that veterans are 57% more likely to die by suicide than non-veteran U.S. adults. Rural veterans are about 20% more likely to die by suicide compared to urban veterans.

These studies demonstrate that rural settings add extra challenges to the already complex nature of veteran care. 

Research compiled by the U.S. Government Accountability Office (GAO) shows that rural veterans face unique barriers to accessing mental health care, including staff shortages in rural facilities and transportation issues. In fact, only about 21% of rural veterans use outpatient care services — less than a third of the rate of their urban counterparts.  

Dr. Amyot pointed to Nebraska’s digital divide, referring to the reduced likelihood of rural residents having adequate broadband access. 

Without the possibility of telehealth visits in many cases, the Grand Island VA mitigates remote geographic challenges by offering transportation services and home-based primary care — a significant benefit largely unavailable in the private health care sector. 

In addition to bridging the physical gap for patients, Grand Island VA has also invested in highly researched training for its therapy professionals. As a result, they have established what is called the Primary Care Mental Health Integration team. 

“If a veteran comes into a primary care appointment and has any kind of mental health concern, they can see somebody that same day,” Dr. Krebs said. 

The Primary Care Mental Health Integram team ensures immediate, high-quality care for veterans experiencing symptoms of anxiety, depression, post-traumatic stress disorder and more. 

“Rural communities still hold onto that ideal of helping each other out, and I think that that’s the way veterans think,” Dr. Amyot said. “You never leave somebody behind, you have a care and a desire to help those around you. [It’s] the Nebraska Way. You take care of each other. I can’t imagine anything better.” 

If you are a veteran in crisis or concerned about one, the Veterans Crisis Line is there for you. Dial 988, then press 1 or text 838255 for free confidential support 24/7, 365 days a year. You don’t have to be enrolled in VA benefits or health care to call. When you call the Veterans Crisis Line, you will be connected to someone qualified to support veterans.


DeAngelis, T. (2022, November 1). Veterans are at higher risk for suicide. Psychologists are helping them tackle their unique struggles. American Psychological Association. 

Office of Mental Health and Suicide Prevention. (2022). National Veteran Suicide Prevention Annual Report. In U.S. Department of Veteran Affairs

Office of Rural Health. (n.d.). Rural Veterans. U.S. Department of Veteran Affairs

VA Mental health: Additional action needed to assess rural veterans’ access to intensive care. (2023, February 9). U.S. Government Accountability Office