Veterans Access to Mental Healthcare

Veterans living in rural areas comprise 41 percent of all enrollees in the VA healthcare system with the majority of veterans treated at one of the Veterans Administration’s 833 Community-based Outpatient Clinics (CBOC).

The VA’s Office of Rural Health (ORH) www.ruralhealth.va.gov wants to be sure that all of the veterans in rural areas can receive mental health treatments within the CBOC setting. To support this goal several research projects are being undertaken by the VA’s initiative called “Collaborative Research to Enhance and Advance Transformation and Excellence” or referred to as CREATE www.hsrd.research.va.gov/centers/create.

CREATE research is helping VA’s efforts in policy-making and program development and enables evidence-based mental health services to be delivered in CBOCs. To accomplish this goal, CREATE has projects measuring veterans access to mental health services, testing access interventions to increase mental health care, and testing clinical interventions to improve quality and mental health outcomes at CBOCs.

One of the CREATE research projects titled “Adapting and Implementing the Blended Collaborative Care Model in CBOCs” uses a multi-site trial to test the impact of restructuring mental health care in CBOCs.

The plan is to transform the care from a referral-based model into a tele-integrated Primary Care Mental Health Integration (PC-MHI) model. Investigators expect that project results will help establish adapting PC-MHI models using telemedicine technologies for clinics that do not have onsite psychologists/psychiatrists.