VACO OFFICE OF MENTAL HEALTH SERVICES UPDATE

1. VACO OFFICE OF MENTAL HEALTH SERVICES UPDATE Antonette M. Zeiss, Ph.D. Deputy Chief Consultant, Office of Mental Health Services Department of Veterans Affairs

2. GROWTH IN PSYCHOLOGY STAFF • Psychology staffing levels going up • Staffing will continue to go up as funded positions are filled • Recruitment incentives have been added to speed hiring • Promotion to GS 14 /15 is a barrier to recruitment and retention of Psychologists

3. PSYCHOLOGY STAFF GS 11-15

4. PSYCHOLOGY STAFF GS14-15

5. PSYCHOLOGY STAFF GS15

6. MENTAL HEALTH INITIATIVE FUNDED POSITIONS IN PSYCHOLOGY • FY 2005: 118 psychologist positions • FY 2006: 227 psychologist positions • FY 2007: 465 psychologist positions to date • TOTAL: 810

7. SPECIFIC MAJOR AREAS OF PSYCHOLOGY STAFF AWARDS • Integrated care: • MH provider in CBOCs: 301 sites, 82 Psychologists • Home Based Primary Care: 108 Psychologists • MH provider in Primary Care Clinic: 101 Psychologists; in co-located, collaborative care or blended model • Local Recovery Coordinators

8. HR RECRUITMENT PACKAGE • Employee referral program • Educational conferences and job fairs • Ad materials • Education debt reduction program • no takers - ???

9. OTHER TOPICS/ACTIONS: OVERSIGHT • Monthly monitoring of hiring and spending; associated Performance Monitor • Please help facilities/VISNs prepare • targets of change are HR and facility Directors • OMHS program review update • GPRA requirement • Facility survey about to be sent • Please help complete

10. VA AND OTHER ORGANIZATIONS • IOM: C&P PTSD report • Evaluation and certification update • VA requested and welcomes • Response forthcoming • DoD Mental Health Task Force • Congressionally mandated • Major focus is DoD mental health care • Some attention to continuity of care with VA

11. VA/DoD joint Mental Health Work Group • Part of efforts to enhance collaboration • Various efforts, including dissemination, information sharing • Commission on Accreditation • Expanded slots for internship and postdoc positions • No specific VA slots, but great respect for and expectation of VA representation • I serve on recommendation committee

12. MEDICAL STAFF • Not all medical facilities have Psychologists as members of medical staff with clinical privileges • Two issues: fairness and C&P eligibility • Instructed by Dr. Kussman to develop directive to make medical staff membership a required standard

13. EVIDENCE-BASED CARE • Central to MHSP • Goal = ensure that psychotherapies shown to be effective are available to veterans • Actions to promote dissemination at full skill level, not just didactic exposure, for PTSD: • Cognitive Processing Therapy • Prolonged Exposure Therapy • Two EBP centers to promote PSR and EBP for other mental health problems

14. MONITORING IMPACT • Not randomized, controlled trial methodology • The goal is to create a process in which • Implementation of evidence-based practice becomes a reality • Problems in implementation are identified and addressed

15. SUPPLEMENTAL BUDGET • Perhaps: another $120 to $150 million • “No year” money • Grows out of Congressional concern that we do everything possible to meet needs of OEF/OIF vets