scholarly journals Burnout in veterans health administration mental health providers in posttraumatic stress clinics.

2014 ◽  
Vol 11 (1) ◽  
pp. 50-59 ◽  
Author(s):  
Hector A. Garcia ◽  
Cindy A. McGeary ◽  
Donald D. McGeary ◽  
Erin P. Finley ◽  
Alan L. Peterson
Keyword(s):  
Mental Health ◽  
Posttraumatic Stress ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Mental Health Providers ◽  
Health Providers ◽  
Health Administration

Bridging the Gap for Perinatal Veterans: Care by Mental Health Providers at the Veterans Health Administration

2019 ◽  
Vol 29 (3) ◽  
pp. 274-282 ◽  
Author(s):  
Aimee R. Kroll-Desrosiers ◽  
Sybil L. Crawford ◽  
Tiffany A. Moore Simas ◽  
Melissa A. Clark ◽  
Kristin M. Mattocks
Keyword(s):  
Mental Health ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Mental Health Providers ◽  
Health Providers ◽  
Health Administration

Embedding new clinical practices: the role of facilitation in enhancing web-based training for mental health providers

2017 ◽  
Vol 12 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Michael R. Kauth ◽  
Geri Adler ◽  
Stephen J. McCandless ◽  
Wendy S. Leopolous
Keyword(s):  
Mental Health ◽  
Dialectical Behavior Therapy ◽  
Veterans Health ◽  
Mental Health Providers ◽  
Health Providers ◽  
Health Administration ◽  
Clinical Practices ◽  
Web Based ◽  
Content Type ◽  
Skills Group

Purpose External facilitation has been shown to increase the implementation and aid sustainment of new clinical practices. The purpose of this paper is to describe the addition of facilitation to web-based training on dialectical behavior therapy (DBT) skills to promote adoption of this intervention among diverse mental health providers at US Veterans Health Administration facilities. Design/methodology/approach In total, 41 participants completed six web-based modules and met in two groups monthly over nine months by telephone with a facilitator who was also an experienced DBT skills group therapist. All participants agreed to conduct a DBT skills group as part of training. The facilitators employed a variety of engagement strategies to meet the evolving needs of participants during the training period. Participants completed an online evaluation of the modules and their facilitation experience at six weeks post-training and responded to an e-mail query at five months post-training about conducting a DBT group. Findings Overall, participants found the training and monthly interprofessional calls with the facilitator useful. Five months post-training, 33 of 41 participants reported conducting a DBT skills group, thus improving access to this intervention. Participants said the biggest barrier to training was finding time during clinic hours to complete the modules, despite assurances of support from local leaders. Originality/value This project provides evidence that virtual facilitation enhances training and promotes the adoption of new clinical practices.

scholarly journals Provider perspectives on a clinical demonstration project to transition patients with stable mental health conditions to primary care

2019 ◽  
Author(s):  
Terri L Fletcher ◽  
Adrienne L Johnson ◽  
Bo Kim ◽  
Zenab Yusuf ◽  
Justin Benzer ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Qualitative Interviews ◽  
Veterans Health ◽  
Mental Health Providers ◽  
Health Providers ◽  
Health Administration ◽  
Provider Education ◽  
Provider Perspectives

Abstract Research to improve access to mental healthcare often focuses on increasing timely referrals from primary care (PC) to specialty mental health (SMH). However, timely and appropriate transitions back to PC are indispensable for increasing access to SMH for new patients. We developed and implemented a formalized process to identify patients eligible for transition from SMH to PC. The FLOW intervention was piloted at a Veterans Health Administration community-based outpatient clinic. Qualitatively examine provider perspectives regarding patient transitions at initiation and termination of the FLOW project. Sixteen mental health providers and three PC staff completed qualitative interviews about the benefits and drawbacks of FLOW at initiation. Ten mental health providers and one PC staff completed interviews at 12-month follow-up. Primary benefits anticipated at initiation were that FLOW would increase access to SMH, provide acknowledgment of veterans’ recovery, and differentiate between higher and lower intensity mental health services. SMH providers reported additional perceived benefits at 12-month follow-up, including decreased stress over their caseloads and increased ability to deliver efficient, effective treatment. Anticipated drawbacks at initiation were that veterans would get inconsistent care, PC could not offer the same level of care as SMH, and veterans might view transition as a rejection by their SMH provider. Perceived drawbacks were similar at 12-month follow-up, but there was less frequent endorsement. Findings highlight need for sustained and frequent provider education regarding (i) the appropriate characteristics of individuals eligible for transition and (ii) established procedures to ensure care coordination during and after transition.

Veterans Health Administration Mental Health Program Evaluation Technical Manual

2009 ◽  
Author(s):  
Marcela Horovitz-Lennon ◽  
Katherine E. Watkins ◽  
Harold Alan Pincus ◽  
Lisa R. Shugarman ◽  
Brad Smith ◽  
...  
Keyword(s):  
Mental Health ◽  
Program Evaluation ◽  
Health Program ◽  
Mental Health Program ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Technical Manual

scholarly journals Predictors of Veterans Health Administration utilization and pain persistence among soldiers treated for postdeployment chronic pain in the Military Health System

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rachel Sayko Adams ◽  
Esther L. Meerwijk ◽  
Mary Jo Larson ◽  
Alex H. S. Harris
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Chronic Pain ◽  
Veterans Health Administration ◽  
First Year ◽  
Veterans Health ◽  
Health Administration ◽  
Military Health System ◽  
Military Health ◽  
The Military

Abstract Background Chronic pain presents a significant burden for both federal health care systems designed to serve combat Veterans in the United States (i.e., the Military Health System [MHS] and Veterans Health Administration [VHA]), yet there have been few studies of Veterans with chronic pain that have integrated data from both systems of care. This study examined 1) health care utilization in VHA as an enrollee (i.e., linkage to VHA) after military separation among soldiers with postdeployment chronic pain identified in the MHS, and predictors of linkage, and 2) persistence of chronic pain among those utilizing the VHA. Methods Observational, longitudinal study of soldiers returning from a deployment in support of the Afghanistan/Iraq conflicts in fiscal years 2008–2014. The analytic sample included 138,206 active duty soldiers for whom linkage to VHA was determined through FY2019. A Cox proportional hazards model was estimated to examine the effects of demographic characteristics, military history, and MHS clinical characteristics on time to linkage to VHA after separation from the military. Among the subpopulation of soldiers who linked to VHA, we described whether they met criteria for chronic pain in the VHA and pain management treatments received during the first year in VHA. Results The majority (79%) of soldiers within the chronic pain cohort linked to VHA after military separation. Significant predictors of VHA linkage included: VHA utilization as a non-enrollee prior to military separation, separating for disability, mental health comorbidities, and being non-Hispanic Black or Hispanic. Soldiers that separated because of misconduct were less likely to link than other soldiers. Soldiers who received nonpharmacological treatments, opioids/tramadol, or mental health treatment in the MHS linked earlier to VHA than soldiers who did not receive these treatments. Among those who enrolled in VHA, during the first year after linking to the VHA, 49.7% of soldiers met criteria for persistent chronic pain in VHA. Conclusions The vast majority of soldiers identified with chronic pain in the MHS utilized care within VHA after military separation. Careful coordination of pain management approaches across the MHS and VHA is required to optimize care for soldiers with chronic pain.

Association between acute psychiatric bed availability in the Veterans Health Administration and veteran suicide risk: a retrospective cohort study

2021 ◽  
pp. bmjqs-2020-012975
Author(s):  
Peter J Kaboli ◽  
Matthew R Augustine ◽  
Bjarni Haraldsson ◽  
Nicholas M Mohr ◽  
M Bryant Howren ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Suicide Risk ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Bed Occupancy ◽  
Increased Risk

BackgroundVeteran suicides have increased despite mental health investments by the Veterans Health Administration (VHA).ObjectiveTo examine relationships between suicide and acute inpatient psychiatric bed occupancy and other community, hospital and patient factors.MethodsRetrospective cohort study using administrative and publicly available data for contextual community factors. The study sample included all veterans enrolled in VHA primary care in 2011–2016 associated with 111 VHA hospitals with acute inpatient psychiatric units. Acute psychiatric bed occupancy, as a measure of access to care, was the main exposure of interest and was categorised by quarter as per cent occupied using thresholds of ≤85%, 85.1%–90%, 90.1%–95% and >95%. Hospital-level analyses were conducted using generalised linear mixed models with random intercepts for hospital, modelling number of suicides by quarter with a negative binomial distribution.ResultsFrom 2011 to 2016, the national incidence of suicide among enrolled veterans increased from 39.7 to 41.6 per 100 000 person-years. VHA psychiatric bed occupancy decreased from a mean of 68.2% (IQR 56.5%–82.2%) to 65.4% (IQR 53.9%–79.9%). VHA hospitals with the highest occupancy (>95%) in a quarter compared with ≤85% had an adjusted incident rate ratio (IRR) for suicide of 1.10 (95% CI 1.01 to 1.19); no increased risk was observed for 85.1%–90% (IRR 0.96; 95% CI 0.89 to 1.03) or 90.1%–95% (IRR 0.96; 95% CI 0.89 to 1.04) compared with ≤85% occupancy. Of hospital and community variables, suicide risk was not associated with number of VHA or non-VHA psychiatric beds or amount spent on community mental health. Suicide risk increased by age categories, seasons, geographic regions and over time.ConclusionsHigh VHA hospital occupancy (>95%) was associated with a 10% increased suicide risk for veterans whereas absolute number of beds was not, suggesting occupancy is an important access measure. Future work should clarify optimal bed occupancy to meet acute psychiatric needs and ensure adequate bed distribution.

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