scholarly journals Impacts of a web-based educational program for veterans who read their mental health notes online

2018 ◽  
Vol 26 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Lauren M Denneson ◽  
Maura Pisciotta ◽  
Elizabeth R Hooker ◽  
Amira Trevino ◽  
Steven K Dobscha
Keyword(s):  
Mental Health ◽  
Mental Health Treatment ◽  
Educational Program ◽  
Patient Activation ◽  
Patient Portal ◽  
Veterans Health ◽  
Health Administration ◽  
Perceived Efficacy ◽  
Web Based ◽  
User Input

Abstract Objective This study evaluates whether a web-based educational program for patients who read their mental health notes online improves patient-clinician communication and increases patient activation. Methods The web-based educational program, developed with end-user input, was designed to educate patients on the content of mental health notes, provide guidance on communicating with clinicians about notes, and facilitate patients’ safe and purposeful use of their health information. Eligible patients were engaged in mental health treatment (≥1 visit in the prior 6 months) and had logged into the Veterans Health Administration (VHA) patient portal at least twice. Participants completed measures of patient activation, perceived efficacy in healthcare interactions, patient trust in their clinicians, and patient assessment of the therapeutic relationship before and after participating in the program. A total of 247 participants had complete data and engaged with the program for 5 minutes or more, comprising the analytic sample. Multivariate analysis using mixed effects models were used to examine pre-post changes in outcomes. Results In bivariate analyses, patient activation, perceived efficacy in healthcare interactions, and trust in clinicians increased significantly between pre- and post-training assessments. In fully adjusted models, changes in patient activation [b = 2.71 (1.41, 4.00), P < 0.01] and perceived efficacy in healthcare interactions [b = 1.27 (0.54, 2.01), P < 0.01)] remained significant. Conclusions Findings suggest that this educational program may help empower mental health patients who read their notes online to be active participants in their care, while also providing information and tools that may facilitate better relationships with their clinicians.

Mental health and addiction service use among United States veterans with liver disease nationally in the Veterans Health Administration

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lamia Haque ◽  
Robert Rosenheck
Keyword(s):  
Mental Health ◽  
United States ◽  
Drug Dependence ◽  
Mental Health Treatment ◽  
Addiction Treatment ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Health Treatment ◽  
Content Type

Purpose While many studies have shown that liver diseases (LD) can be caused or exacerbated by substance use disorders (SUD), few have examined the proportion of adults with LD and SUD who receive mental health and addiction treatment or correlates of such use. Design/methodology/approach Using national Fiscal Year (FY) 2012 data from the United States Veterans Health Administration (VHA), the authors studied all 43,246 veterans diagnosed with both LD and SUD in FY 2012 and compared those who received mental health treatment (n = 30,456; 70.4%) to those who did not (n = 12,790; 29.6%). Findings Veterans who received mental health treatment were less like to be older than 75 years of age, more likely to have served during recent Middle East conflicts (Operation Iraqi Freedom or Operation Enduring Freedom), more likely to have been recently homeless and to have drug dependence as contrasted with alcohol dependence when compared with those who did not receive mental health treatment. Although the majority, 70.4%, received mental health treatment, only 30.6% of the total received specialized addiction treatment, and these veterans were more likely to experience homelessness and have drug dependence diagnoses. Originality/value This is the first study as per the authors’ best knowledge that broadly examines mental health and addiction treatment received by veterans with LD and SUD. High rates of mental health treatment in this population likely reflect the integrated nature of the VHA and its emphasis on providing comprehensive services to homeless veterans. Further research is needed to identify barriers to specialized addiction treatment in this population.

Process mapping appointments to identify improvements in care delivered to patients who screen positive for depression

2016 ◽  
Vol 4 (3) ◽  
pp. 433
Author(s):  
Bo Kim ◽  
Stephanie Rodrigues ◽  
Natalie S Dell ◽  
Rani Elwy
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Treatment ◽  
Veterans Health ◽  
Health Administration ◽  
Depression Care ◽  
Positive Screen ◽  
Novel Approach ◽  
Using Data

Rationale, aims and objectives  After screening positive for depression, many patients do not receive effective medication or maintain optimal contact with practitioners.  Our objective was to examine how appointments that patients have after screening positive may affect the delivery of evidence-based and guideline-concordant depression care. Methods  We reviewed treatment records for 271 patients who screened positive for depression in primary care across three United States Veterans Health Administration medical facilities.  For each patient, we mapped the process of appointments that took place following the positive screen, noting the number of appointments, the service line in which each appointment was held, as well as whether guideline-concordant depression care was in turn received over four months. Results  We found that (i) approximately half of the patients who screened positive had no follow-up appointments, (ii) all patients who had two or more follow-up appointments received some – but not necessarily guideline-concordant – mental health treatment, and (iii) there were distinct patterns across the three facilities regarding which service lines’ appointments most often resulted in treatment. Conclusions  Our work offers a novel approach of using data on appointments that patients have after screening positive for depression to shed light on current care practices.  The number of post-screening appointments can be an informative process measure for improving depression care to become more guideline-concordant.  Facilities vary substantially in terms of which service lines they use to attain guideline-concordance, likely due to notable differences in how their primary care, integrated primary care behavioral health, and mental health services are organized.

scholarly journals Implementation and evaluation of a pharmacist-run mental health treatment clinic via clinical video telehealth

2016 ◽  
Vol 6 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Molly Leach ◽  
Guadalupe Garcia ◽  
Nicole Ganzer
Keyword(s):  
Mental Health ◽  
Rural Areas ◽  
Mental Health Treatment ◽  
Medical Center ◽  
Medication Management ◽  
Health Resources ◽  
Cost Savings ◽  
Veterans Health ◽  
Health Administration ◽  
Potential Cost

Abstract Introduction: The Veterans Health Administration is extending its mental health services to reach those in rural areas who find it difficult to travel to a Veterans Affairs Medical Center (VAMC). This project aimed to outline implementation of a Pharmacy Mental Health Clinical Video Telehealth (MHCVT) clinic for veterans. Secondary endpoints were to assess patient satisfaction with MHCVT, describe the potential benefits of this clinic regarding travel saved, and summarize no-show rates. Methods: Veterans received mental health disease state medication management from a mental health clinical pharmacy specialist via clinical video telehealth (CVT) in place of an in-clinic appointment and were asked to complete a satisfaction survey after the initial CVT appointment. Data collected from all veterans enrolled in the CVT clinic from September 8, 2014, through March 23, 2015 included: patient demographics, service connection percentage, number of CVT visits, travel miles saved, travel reimbursement, no-show rate, and documentation of medication management therapy. Results: As of March 23, 2015, there were 22 veterans enrolled in the MHCVT clinic, of whom, 19 completed their appointments. Of the 48 potential encounters, 7 were considered a no-show (17%). On average veterans saved 34 travel miles per visit with cumulative savings of 1432.6 miles. Of those who were eligible to receive travel reimbursement (n = 13), the medical center potentially saved $674.50 in a 7-month period. Overall clinic satisfaction per survey (n = 14) was 100% (strongly agreed or agreed). A majority (93%) would recommend the clinic to other veterans. Conclusions: This project successfully implemented a MHCVT pilot clinic. The veterans were satisfied with the services. The 41 clinic visits resulted in a potential cost savings. Expansion of this clinic in the future will expand more mental health resources to veterans.

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.

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
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