Evaluation of the Department of Veterans Affairs Mental Health Services (2018) / Chapter Skim
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12 Efficient Mental Health Care
12 Efficient Mental Health Care
Pages 253-264
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From page 253... ...
currently tracks onboard outpatient mental health providers. However, data on mental health workforce provided by OMHSP to the committee did not include information about either social workers or nurses, two of the core mental health professions.
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. CARE INTEGRATION AND COLLABORATION In this section, the committee presents information about the VA's use of evidence-based care delivery approaches that systematically coordinate care given by the VA's primary care, mental health, and substance-use treatment providers to effectively treat patients with mental health conditions.
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. The 2014 Institute of Medicine report Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment urged the VA and the Department of Defense to expand integrated and coordinated care for posttraumatic stress disorder (PTSD)
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From page 256... ...
, treatment adherence monitoring, and patient education. The care management approaches supported in VA primary care settings include the Behavioral Health Laboratory, which provides evidence-based clinical services supporting mental health and substance abuse management as well as Translating Initiatives in Depression into Effective Solutions (Beehler et al., 2015)
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From page 257... ...
To explore PC-MHI provider adherence to PC-MHI-specific tasks or procedures, the investigators analyzed self-report data captured with a psychometrically valid instrument, the Primary Care Behavioral Health Provider Adherence Questionnaire. The respondents were 173 VHA mental health providers (30 percent response rate)
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Stepped-Care Approaches As barriers to mental health care remain exacerbated by growing demand and shortage of manpower, a type of integrated care, called stepped care, is being viewed as a strategy to achieve greater service efficiency. Stepped care seeks to treat patients at the lowest appropriate intensity of care that is still likely to provide benefits, to monitor a patient's progress longitudinally, and to reserve more intensive treatments for those patients who do not benefit from first-line treatments or for those with more complex clinical presentations (Firozi, 2017; VA, 2016b)
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, researchers compared a stepped-care model, Stepped Enhancement of PTSD Services Using Primary Care (STEPS-UP) with the usual care, an integrated mental health approach called RESPECT-Mil.
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In New York State, a partnership between the VA health system and a private-sector provider was established to create a mental health center that co-locates and coordinates care for veterans and their families. The Northwell Health System and the Northport Veterans Affairs Medical Center created the Unified Behavioral Health Center (UBHC)
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From page 261... ...
In contrast to the mixed reviews of group therapy for substance use disorder and mental problems, another type of group -- psychoeducational -- was viewed as helpful. Most VA medical centers provide psychoeducational groups -- or "classes," as veterans and VA clinicians referred to them.
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We're doing our job." [Chicago, Illinois] SUMMARY Based on findings from the committee's site visits and literature research, this chapter presented information about evidence-based care delivery approaches that achieve efficiency by systematically coordinating care given by VA primary care, mental health, and substance-use treatment providers in order to effectively treat patients with mental health conditions.
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2016. Innovating team-based outpatient mental health care in the Veterans Health Administration: Staff-perceived benefits and challenges to pilot implementation of the Behavioral Health Interdisciplinary Program (BHIP)
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2016. Evolving models of behavioral health integration: Evidence update 2010–2015.
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