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Partnership with theMental Health Product Line
Kathy L. Henderson, MDMichael R. Kauth, PhD
February 2011
South Central VA Health Care Network Mental Health Product Line
Organizational Chart
Deputy Manager
Administrative Officer
Integrated CareCoordinator
Administrative Support
Assistant
Network Homeless
Coordinator
Deputy Network Homeless
Coordinator
Administrative Support
Assistant
Network Suicide Prevention
Coordinator
Manager
Mental Health Product Line Advisory Council (MHPLAC)
• VISN 16 MHPLAC– Led by VISN 16 MHPL Manager– Composed of Key MH leaders from each facility– Chief of Staff, Social Work, Nurse Representatives– Medical Center Director Champion – Julie Catellier
(New Orleans)– MIRECC Representative—Associate Director for
Clinical Care (Pat Dubbert, PhD)– 18 Program Specific Workgroups
Mental Health Programs
• Inpatient Psychiatry (Acute, Intermediate, STAR)
• Mental Health Residential Treatment Program (Doms, RRTPs)
• Ambulatory Mental Health• Mental Health Disaster Teams• Evidence-based
Psychotherapies• Psychosocial Rehabilitation
(CWT/SE, PRRCs)
• Primary Care MH• MHICM• Homeless Programs• Suicide Prevention• Telemental Health• MST• SUD• PTSD• MH OEF-OIF
MIRECC’s Role with the MHPLAC
• Works with all facilities and CBOCs• Addresses educational priorities/provides training
identified by facilities• Communicates with providers thru newsletter, COP,
individually• Engages CBOC providers in MIRECC mission• Assists with implementation of new clinical programs• Provides direction/consultation for clinical proposals and
educational grants• Voting member of MHPLAC
President’s New Freedom Commission
2003
VHA Comprehensive MH Strategic Plan
2004
Uniform MH Services Handbook
2008
T21 Implementation
2010
Zero Veteran Homelessness
Improve Veterans Mental Health
MH Enhancement InitiativeFTEE & Funding (FY05-FY10)
FTEE CO Funding2005 47.5 $3,399,786
2006 121.55 $10,348,659
2007 161.65 $16,158,344
2008 66.0 $6,457,726
2009 129.15 $12,691,401
2010 33.5 $3, 567,573
VISN 559.35 $52,623,489
90% fills thru September 2010
Growth in Mental Health Uniques (FY05-FY10)
ALX BIL FAV HOU JAC LIT MUS NOL OKL SHR V16-20.00
-10.00
0.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
-16.9
-1.6
16.0
6.7
-16.9
31.2
5.2
-16.0
6.8
-4.5-0.6
34.8
68.2 70.1
43.7
49.6
42.2
33.3
14.4
43.1
24.2
43.0
NonMH MH
Priorities for MHPL
• Implement Uniform MH Services Handbook• Maintain mental health staffing enhancements• Increase access to specialty mental health services
in rural areas• Expand technology
– telemed, social networking, in home treatment• Review need for additional MH specialty/residential
beds• HOMELESS! HOMELESS! HOMELESS!
– Zero homelessness in 4 years
VISN 16 MH Clinical Education Priorities
Only undertake initiatives that are supported by the MHPLAC (often directly related to UMHS Handbook implementation)
MIRECC survey of 10 medical center MH programs and their CBOCs:
VAMC s CBOCs
1. Brief SUD interventions 1. Motivation interviewing, general
2. DBT skills 2. Treating vets with PTSD and TBI
3. Motivational interviewing, general 3. Suicide prevention
4. SUD psychotherapy (CBT) 4. Marital therapy/couples therapy
5. Suicide prevention 5. Brief SUD interventions
Update on Past Projects
1. UMHS DVDs to VISN 16 CBOCswww.mirecc.va.gov/VISN16/umhshs/umhshEducation.asp
2. CBT in VA medical center and community clinics: An implementation pilot – 3 published papers
Kauth, M.R., Sullivan, G., Cully, J., & Blevins, D. (in press). Facilitating practice changes in mental health clinics: A guide for implementation development in health care systems. Psychological Services.
Kauth, M.R., Sullivan, G., Blevins, D., Cully, J.A., Said, Q., Teasdale, T.A., & Landes, R.D. (2010). Employing external facilitation to implement cognitive behavioral therapy in VA clinics: A pilot study. Implementation Science, 5. www.implementationscience.com/content/5/1/75
Cully, J.A., Teten, A.L., Benge, J., Sorocco, K.H., & Kauth, M.R. (2009). Multidisciplinary cognitive-behavioral therapy training for the VA primary care setting. Journal of Clinical Psychiatry: Primary Care Companion, 12(3), e1-e8.
Selected New Projects
Guide to VA Mental Health
Services for Veterans & Familieswww.mirecc.va.gov/visn16/
and in hardcopy
For veterans to know what services are
available where they live and to expect
such services
Selected New Projects
Online Working with Couples Modules
Urgent clinical need by MHPLAC
– Two workshops + consultation in 2009 (Houston, Little Rock) for 58 MH clinicians (40% from CBOCs)
– MIRECC grant to produce 6 online modules + consultation in 2011; pilot with 80 MH clinicians
– Goal = increase training reach
Play clip
Selected New Projects
Promoting Telepsychotherapy
Urgent clinical need by MHPL
CBOC Needs Assessment found TeleHealth system underused
– Team: Kauth, Greene (NCPTSD), Sorocco (OKC VA), Deen (LR VA), Smith (Wichita Falls CBOC)
– Pilot with 13 therapists who will provide EB psychotherapy to 7 clinics
– Assessment barriers and action to resolve + VTEL training with therapists + follow up
– Goal = reduce clinician anxiety; increase comfort; speed implementation
Selected New Projects
TBI Assessment Modules
Urgent clinical need by MHPLAC
– Basics of good TBI assessment– Goal = increase training reach
Play clip