VA Mental Health Services: We

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VA Mental Health ServicesWere Not Your
Fathers VA Anymore!

• Steve Holliday, Ph.D, ABPP-CN
• Chief Mental Health Officer
• Substance Abuse Coordinator
• Veterans Administration, VISN 17

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VISN 17
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Eligibility Issues

• Not Eligible for VA Care while Incarcerated
• Except for brief outreach visits
• OEF/OIF Vets have full eligibility for 5 years
• Must have Honorable or General D/C
• Bad D/Cs can be upgraded
• Served gt180 days or Service-connected
• Co-Pays at Higher Incomes Unless SC

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MH in Primary Care

• Co-located Mental Health in Primary Care
• Reduces Stigma for Seeking MH Care
• Rapid Access for MH Screening/Services
• Treatment for Mild MH issues
• Adjustment Issues/Life Stress
• Uncomplicated Depression Anxiety D/Os
• Harm Reduction/ME for SUDs
• Referral to MHC/Specialized Tx Programs
• Up to 80 of Cases Managed in PCC
• Healthy Behaviors/Disease Mgmt

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Outpatient MH Clinics

• Routine Outpatient MH Care
• MH Case Management
• Psychotropic Medications
• Evidence-based Psychotherapies for
• Depression
• Mild PTSD/Anxiety Disorders
• Psychosis
• Marital/Couples Counseling

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Substance Abuse Treatment

• Building Motivation/Education in PCC MHCs
• Outpatient SUD Program
• Intensive Outpatient SUD Program
• SARRTP (28 Day Residential)
• SUD Tracks in Doms (90-Day Residential)
• Buproprion/Methadone Programs
• Inpatient/Outpatient DETOX

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Homeless Programs

• Ending Homelessness in 5 years!
• Health Care for Homeless Veterans
• Contact Emergency Shelters
• Homeless Domiciliaries
• Grant and Per Diem Transitional Housing
• HUD/VASH Vouchers (10,000 more coming)
• Emergency Cash Assistance to prevent Homelessness

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Vocational Rehabilitation

• VBA Educational Benefits (30 SC)
• Incentive Therapy (IT)
• Compensated Work Therapy (CWT)
• Supported Community Employment
• Job Search Assistance
• Assistance with VA/SSDI Claims (VSOs)
• Volunteer Positions

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Rehabilitation/Recovery Model

• Recovery is possible for everyone (even SMI)
• Its the Vets Recovery Plan Not the Docs
• Uses Understandable Language
• Based on Vets Strengths, Goals
• Peer Counselors/Technicians as Role Models
• Include Consumers in MH Planning/Mgmt
• Meaningful Work is the Best Therapy
• Building Support Systems in the Community
• Educating to Reduce Stigma/Facility Recovery
  Coordinators

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Tele Health Services

• Telemental Health Services
• EBTs from the Hospitals to Remote Clinics
• Cross coverage for Smaller MHCs
• Health Buddies to Monitor SMI at Home
• Home-based Videophones for Highly Rural
• Reduces Barriers of Distance Stigma
• Future Directions
• Anonymous Chat Rooms (Suicide Hot Line)
• Peer Support Networks
• Secure Email with MH Providers

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Distance Consultation
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OEF/OIF Resources

• www.texvet.com
• On Line Searchable Database
• Texas MH, Job, Education, Emergency Services
• Eligibility Tool Under Development
• 211 Texas
• Just Dial 211
• 24/7 Information Line
• Services for Vets/Active Duty
• Vet Centers
• Storefront locations, walk-in service
• Veteran and Family Counseling
• GWAT Outreach Staff

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The Best Medical Care in the U.S.

• The VA uses the data gathered in its computers
  to pinpoint problem areas, such as medication
  errors. The network also allows it to track how
  closely the medical staff is following
  evidence-based treatment and monitor
  deficiencies. Such tracking pays off. When Rand
  did an extensive study comparing quality of care
  at the VA with private-sector hospitals, it found
  that performance measurement played an important
  role in helping the VA score higher in every
  category except acute care, where it came in
  about even.
• Business Week, 2006

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VA medical system earns high customer
satisfaction ratings

• Good news about government is rare enough.
  What's outright shocking is when that good news
  is about how nice government employees are. But
  that is the bottom line of the recently released
  American Customer Satisfaction Index report on
  the Department of Veterans Affairs' medical
  system.
• Not only do veterans rate their VA care much
  higher overall than the general population rates
  its hospital experiences, vets also consistently
  give VA doctors and nurses high scores for
  "responsiveness" (83 out of a possible 100),
  courtesy (90), and "respect and dignity afforded
  patients" (91).
• National Journal February 10, 2006

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