Evaluation of the Department of Veterans Affairs Mental Health Services (2018) / Chapter Skim
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16 Findings, Conclusions, and Recommendations
16 Findings, Conclusions, and Recommendations
Pages 321-334
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From page 321... ...
The committee's survey found that • Of an estimated 4.2 million OEF/OIF/OND veterans, 41 percent of veterans have a potential need for mental health services. Veterans were considered to have a mental health need if they had a positive result on at least one of five mental health screeners or had reported being told by a health professional they have a mental health condition.
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From page 322... ...
Among those who have a mental health need who have not sought VA mental health services, their main reasons are they do not know how to apply for VA mental health care benefits, they are unsure whether they are eligible, or they are unaware that the VA offers mental health care benefits. The same reasons were frequently reported by veterans interviewed on the site visits.
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From page 323... ...
. A lower percentage of non-VA users who have mental health need reported that it is very easy, somewhat easy, or neither easy nor hard to get to the nearest VA facility that offers mental health services compared with VA users who have mental health need (49 versus 75 percent)
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From page 324... ...
throughout the VA's health care system and for training its providers to use them. • While studies comparing the quality of mental health care received by veteran versus civilian populations are scarce, there are data showing that the VA performs favorably on key measures of mental health care quality when compared to private health plans.
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From page 325... ...
, telehealth, virtual care technologies, and tele-mental health research and app development. • The VA has many data systems tracking patient care; however, it has not yet systematically collected and reported standardized patient-reported outcome measures.
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From page 326... ...
Furthermore, the VA is positioned to inform and influence how mental health care services are provided more broadly in the United States. After reviewing extensive evidence, which was presented in earlier chapters of this report, the committee concludes that the VA provides mental health care that is generally of comparable or superior quality to mental health care that is provided in the private and non-VA public sectors and that it has multiple centers of excellence in various aspects of mental health care.
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From page 327... ...
The lack of awareness about how to connect to the VA for mental health care demonstrates the need for awareness campaigns and effective dissemination of the mental health care opportunities, eligibility criteria, and services to help veterans understand how and where to access mental health care. The VA's recent initiative to offer emergency mental health care to veterans with other-than-honorable discharge status is an important step in improving access for veterans who may be in need of immediate help.
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From page 328... ...
Several of these resources are described in Chapter 9. These resources generally provide ancillary and complementary services to support mental health treatment obtained from VA providers and from community care providers such as Veterans Choice Program providers.
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From page 329... ...
The committee heard from women veterans during the site visits that staff at VA health facilities sometimes assumes that they are wives accompanying their husbands and not themselves veterans. They also are at times uncomfortable in VA clinic waiting rooms because they get unwanted sexual attention which can be particularly unsettling for women veterans who have experienced military sexual trauma.
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From page 330... ...
Primary care–mental health integration is one strategy that the VA has employed to realign its human resources to reduce service fragmentation and improve patient care. While the VA needs to ensure that its existing mental health care resources are allocated in a manner that optimizes the likelihood that they are effectively and efficiently used, it was clear to the committee that additional staff and clinical space are needed at some facilities.
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From page 331... ...
Health Technology In its review of the literature and its analyses of its survey and site visit information, as detailed in Chapters 6 and 14, the committee found that the VA is using health technology, including telemedicine (the use of electronic information and communication technologies to provide health care) and mHealth (mobile health apps)
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From page 332... ...
The VA is already a widely recognized leader in the research and development of, as well as the implementation and use of, electronic health records, telemedicine, and clinical information technologies such as mHealth to be used at the provider–veteran interface, but the potential value of this infrastructure and personnel capacity and strength is not currently being fully realized. The VA needs to move from this position of strength and set quantitative targets for the use of virtual care technologies (for example, to have 30 percent of all mental health consultations being performed online within 3 years)
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From page 333... ...
Recent efforts include the expansion of quality management data systems (such as Strategic Analytics for Improvement and Learning and the Mental Health Management System) with more measures of mental health care, the use of performance data to encourage greater engagement by VA management in mental health programming and improvement, the conduct of research (through Quality Enhancement Research Initiative resources, for example)
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From page 334... ...
The committee found that quality performance data are routinely reported internally and publicly to support and incentivize ongoing quality improvement and to facilitate transparency. The VA also is demonstrating efforts to use and improve upon resources, such as the new Diffusion of Excellence Initiative, for disseminating best practices.
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