A Role for OT Collaboration With Vocational Rehabilitation Specialists Providing Individualized Community-Based Services to Younger Rural Veterans?

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512510252p1-7512510252p1
Author(s):  
Consuelo Kreider ◽  
Zaccheus J. Ahonle ◽  
Jennifer L. Hale-Gallardo ◽  
Gail Castaneda ◽  
Kimberly Findley ◽  
...  
Keyword(s):  
Vocational Rehabilitation ◽  
Veterans Health ◽  
Promising Practices ◽  
Community Based ◽  
Vocational Services ◽  
Community Based Services ◽  
Primary Author

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. An in-depth description is provided of the implementation of the Veterans Health Administration’s Rural Veterans Tele-Rehabilitation Initiative in supporting development and expansion of individualized community-based vocational services to rural veterans with disabling conditions. Promising practices and opportunities for OT collaborations with vocational rehabilitation specialists were identified. Primary Author and Speaker: Consuelo Kreider Contributing Authors: Zaccheus J. Ahonle, Jennifer L. Hale-Gallardo, Gail Castaneda, Kimberly Findley, and Sergio Romero

scholarly journals Social Determinants of Mental Health Care Systems: Intensive Community Based Care in The Veterans Health Administration

2020 ◽  
Author(s):  
Ish P Bhalla ◽  
Elina A Stefanovics ◽  
Robert A Rosenheck
Keyword(s):  
Mental Health ◽  
Social Determinants ◽  
Public Mental Health ◽  
Veterans Health Administration ◽  
Outpatient Clinics ◽  
Veterans Health ◽  
Health Administration ◽  
Community Based ◽  
Community Based Programs ◽  
Community Based Services

Abstract Background: Since deinstitutionalization in the 1950s-1970s, public mental health care has changed its focus from asylums to general hospitals, outpatient clinics and specialized community-based programs addressing both clinical and social determinants of mental health. Analysis of the place of community-based programs within a comprehensive health system such as the Veterans Health Administration (VHA) may illuminate the role of social forces in shaping contemporary public mental health systems. Methods: National VHA administrative data were used to compare veterans who exclusively received outpatient clinic care to those receiving four types of specialized community-based services, addressing: 1) functional disabilities from severe mental illness (SMI), 2) justice system involvement, 3) homelessness, and 4) vocational rehabilitation. Bivariate comparisons and multinomial logistic regression analyses compared groups on demographics, diagnoses, service use, and psychiatric prescription fills. Results: An hierarchical classification of 1,386,487 Veterans who received specialty mental health services from VHA in Fiscal Year 2012, showed 1,134,977 (81.8%) were seen exclusively in outpatient clinics; 27,931 (2.0 %) received intensive SMI-related services; 42,985 (3.1%) criminal justice services; 160,273 (11.6%) specialized homelessness services; and 20,921 (1.5%) vocational services. Compared to those seen only in clinics, veterans in the four community treatment groups were more likely to be black, diagnosed with HIV and hepatitis, had more numerous substance use diagnoses and made far more extensive use of mental health outpatient and inpatient care. Conclusions: Almost one-fifth of VHA mental health patients receive community-based services prominently addressing major social determinants of health and multimorbid substance use disorders.

scholarly journals Social Determinants of Mental Health Care Systems: Intensive Community Based Care in The Veterans Health Administration

2020 ◽  
Author(s):  
Ish P Bhalla ◽  
Elina A Stefanovics ◽  
Robert A Rosenheck
Keyword(s):  
Mental Health ◽  
Social Determinants ◽  
Public Mental Health ◽  
Veterans Health Administration ◽  
Outpatient Clinics ◽  
Veterans Health ◽  
Health Administration ◽  
Community Based ◽  
Community Based Programs ◽  
Community Based Services

Abstract Background: Since deinstitutionalization in the 1950s-1970s, public mental health care has changed its focus from asylums to general hospitals, outpatient clinics and specialized community-based programs addressing both clinical and social determinants of mental health. Analysis of the place of community-based programs within a comprehensive health system such as the Veterans Health Administration (VHA) may illuminate the role of social forces in shaping contemporary public mental health systems. Methods: National VHA administrative data were used to compare veterans who exclusively received outpatient clinic care to those receiving four types of specialized community-based services, addressing: 1) functional disabilities from severe mental illness (SMI), 2) justice system involvement, 3) homelessness, and 4) vocational rehabilitation. Bivariate comparisons and multinomial logistic regression analyses compared groups on demographics, diagnoses, service use, and psychiatric prescription fills. Results: An hierarchical classification of 1,386,487 Veterans who received specialty mental health services from VHA in Fiscal Year 2012, showed 1,134,977 (81.8%) were seen exclusively in outpatient clinics; 27,931 (2.0 %) received intensive SMI-related services; 42,985 (3.1%) criminal justice services; 160,273 (11.6%) specialized homelessness services; and 20,921 (1.5%) vocational services. Compared to those seen only in clinics, veterans in the four community treatment groups were more likely to be black, diagnosed with HIV and hepatitis, had more numerous substance use diagnoses and made far more extensive use of mental health outpatient and inpatient care. Conclusions: Almost one-fifth of VHA mental health patients receive community-based services prominantly addressing major social determinants of health and multimorbid substance use disorders.

Vocational Services

2013 ◽  
Author(s):  
Lauren B. Gates
Keyword(s):  
Vocational Rehabilitation ◽  
Social Workers ◽  
Physical Disability ◽  
Best Practice ◽  
Supported Employment ◽  
People With Disabilities ◽  
Community Life ◽  
Community Based ◽  
Vocational Services ◽  
Rehabilitation System

Vocational rehabilitation (VR) services, provided through a jointly funded state–federal rehabilitation system and available in each state, help people with disabilities prepare for, secure, and sustain employment. Since 1920, VR Programs have helped 10 million individuals with disabilities reach employment. Anyone with a mental or physical disability is eligible for VR services. While a range of services is provided, the services most consistent with VR goals are those, such as supported employment, that promote full integration into community life. Social workers are essential to community-based VR services; however, a challenge for the profession is to assume new roles to meet best practice vocational standards.

scholarly journals Social Determinants of Mental Health Care Systems: Intensive Community Based Care in The Veterans Health Administration

2020 ◽  
Author(s):  
Ish P Bhalla ◽  
Elina A Stefanovics ◽  
Robert A Rosenheck
Keyword(s):  
Mental Health ◽  
Social Determinants ◽  
Public Mental Health ◽  
Veterans Health Administration ◽  
Outpatient Clinics ◽  
Veterans Health ◽  
Health Administration ◽  
Community Based ◽  
Community Based Programs ◽  
Community Based Services

Abstract Background Since deinstitutionalization in the 1950s-1970s, public mental health care has changed its focus from asylums to general hospitals, outpatient clinics and specialized community-based programs addressing both clinical and social determinants of mental health. Analysis of the place of community-based programs within a comprehensive health system such as the Veterans Health Administration (VHA) may illuminate the role of social forces in shaping contemporary public mental health systems. Methods National VHA administrative data were used to compare veterans who exclusively received outpatient clinic care to those receiving four types of specialized community-based services, addressing: 1) functional disabilities from severe mental illness (SMI), 2) justice system involvement, 3) homelessness, and 4) vocational rehabilitation. Bivariate comparisons and multinomial logistic regression analyses compared groups on demographics, diagnoses, service use, and psychiatric prescription fills. Results An hierarchical classification of 1,386,487 Veterans who received specialty mental health services from VHA in Fiscal Year 2012, showed 1,134,977 (81.8%) were seen exclusively in outpatient clinics; 27,931 (2.0%) received intensive SMI-related services; 42,985 (3.1%) criminal justice services; 160,273 (11.6%) specialized homelessness services; and 20,921 (1.5%) vocational services. Compared to those seen only in clinics, veterans in the four community treatment groups were more likely to be black, diagnosed with HIV and hepatitis, had more numerous substance use diagnoses and made more extensive use of mental health outpatient and inpatient care. Conclusions Almost one-fifth of VHA mental health patients receive specialized community-based services addressing, most prominently, major social determinants of health and multimorbid substance use disorders.

Implementation and use of video tele-technologies in delivery of individualized community-based vocational rehabilitation services to rural veterans

2021 ◽  
pp. 1-19
Author(s):  
Zaccheus J. Ahonle ◽  
Consuelo M. Kreider ◽  
Jennifer. Hale-Gallardo ◽  
Gail. Castaneda ◽  
Kimberly. Findley ◽  
...  
Keyword(s):  
Vocational Rehabilitation ◽  
Rural Areas ◽  
Competitive Employment ◽  
Veterans Health ◽  
Health Administration ◽  
Structured Interviews ◽  
Community Based ◽  
Face To Face ◽  
Vocational Rehabilitation Services ◽  
Employment Rates

BACKGROUND: Telerehabilitation is an effective health delivery method for patients with a variety of health conditions. There is insufficient knowledge about use of telerehabilitation to support patients with disabilities and chronic illness in obtaining or sustaining competitive employment. Employment rates of Veterans are lower than civilian rates, and the employment gap is higher for Veterans living in rural areas. OBJECTIVE: To investigate factors that enabled and constrained routine use of video tele-technologies in delivering individualized community-based vocational rehabilitation (referred to as Tele-VR) services and to identify impacts and promising practices in implementation. METHODS: Semi-structured interviews with providers from two Veterans Health Administration Medical Sites that use telerehabilitation to supplement their existing face-to-face individualized community-based VR services. Interviews were analyzed using thematic analysis. RESULTS: Five themes in the implementation of Tele-VR were identified (1) Enhancing Workflow for Providers, (2) Improving Quality of Therapeutic Care, (3) Practicalities in Implementing Tele-VR, (4) Embedding Vocational Rehabilitation into Interdisciplinary Care as a Facilitator to Implementation, and (5) Impact of Tele-VR. CONCLUSIONS: The telerehabilitation delivery of employment service to Veterans with disabilities is a viable means for remotely providing or enhancing face-to-face individualized and community-based VR services that support Veterans’ competitive employment and job stability within their communities.

scholarly journals Social Determinants of Mental Health Care Systems: Intensive Community Based Care in The Veterans Health Administration

2020 ◽  
Author(s):  
Ish P Bhalla ◽  
Elina A Stefanovics ◽  
Robert A Rosenheck
Keyword(s):  
Mental Health ◽  
Social Determinants ◽  
Public Mental Health ◽  
Veterans Health Administration ◽  
Outpatient Clinics ◽  
Veterans Health ◽  
Health Administration ◽  
Community Based ◽  
Community Based Programs ◽  
Community Based Services

Abstract Background: Since deinstitutionalization in the 1950s-1970s, public mental health care has changed its focus from asylums to general hospitals, outpatient clinics and specialized community-based programs addressing both clinical and social determinants of mental health. Analysis of the place of community-based programs within a comprehensive health system such as the Veterans Health Administration (VHA) may illuminate the role of social forces in shaping contemporary public mental health systems. Methods: National VHA administrative data were used to compare veterans who exclusively received outpatient clinic care to those receiving four types of specialized community-based services, addressing: 1) functional disabilities from severe mental illness (SMI), 2) justice system involvement, 3) homelessness, and 4) vocational rehabilitation. Bivariate comparisons and multinomial logistic regression analyses compared groups on demographics, diagnoses, service use, and psychiatric prescription fills. Results: An hierarchical classification of 1,386,487 Veterans who received specialty mental health services from VHA in Fiscal Year 2012, showed 1,134,977 (81.8%) were seen exclusively in outpatient clinics; 27,931 (2.0 %) received intensive SMI-related services; 42,985 (3.1%) criminal justice services; 160,273 (11.6%) specialized homelessness services; and 20,921 (1.5%) vocational services. Compared to those seen only in clinics, veterans in the four community treatment groups were more likely to be black, diagnosed with HIV and hepatitis, had more numerous substance use diagnoses and made far more extensive use of mental health outpatient and inpatient care. Conclusions: Almost one-fifth of VHA mental health patients receive community-based services prominantly addressing major social determinants of health and multimorbid substance use disorders.

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