evolving policy: focus on access [email protected]
TRANSCRIPT
Mental Health in VA
• It’s about caring for Veterans
• It’s also about politics
Access as a Focus
• Important– In population-based care– In an integrated health system
• Complementary– To quality of care– To continuity and chronic disease models
• Related– To capacity– To allocation of care resources
• Access is readily understandable
Veterans requesting or referred for Mental Health Services will be evaluated within 24 hours.
Operationalizing:
What kind of evaluation?• Triage
– To determine whether emergent or urgent care is needed?• Danger to self• Danger to others• Medical need?
– To determine the appropriate setting for further evaluation and care?
• Emergency department• Inpatient• General mental health• Specialty services• SUD services
– To facilitate arrangements for further care?• Address questions and concerns• Arranging follow-up within two weeks
Operationalizing:
How should it be conducted?
• By a professional– Mental health– Primary care provider?
• In person or, when necessary, by telephone
• May be fee-based
Operationalizing:
When will this be implemented?
• Within a few weeks
• Staging– Implementation for all veterans
• or
– Initial implementation for returning veterans
Operationalizing:
What are possible “unanticipated consequences”?
Operationalizing:
What are possible “unanticipated consequences”?
• Improving access at the expense of quality and continuity
• Consequences related to missing targets
• Increasing stigma
Operationalizing:
What else is being planned?
• Follow-up on missed appointments• Fee basing (components of) care• Clerical and program support• NRM funding to improve access and safety• Suicide prevention hotline• Expansion of Vet Centers• Coordination with VBA• Certification of C&P examiners