VA to boost remote mental health services

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To improve veterans' access to mental healthcare, the Department of Veterans Affairs announced this week that it has set a goal of providing 200,000 remote consultations this year through videoconferencing. The news comes on the heels of the VA's recent announcement that it no longer will charge veterans a co-payment for any telehealth services.

The VA provided 140,000 remote consultations to 55,000 veterans through its community-based outpatient clinics in fiscal year 2011, more than double the rate of use in 2008. It expects to treat 2,000 patients in their homes by the end of fiscal year 2012, including 1,500 through Internet Protocol (IP) video on their personal computers.

In a presentation last month to the American Psychiatric Association, Linda Godleski, director of the national telemental health center and a psychiatrist at Yale University, said the program, which began in the early 2000s as a way to manage medication, has grown to encompass the full spectrum of mental health services, according to Elsevier Global Medical News.

Godleski presented research recently published at Psychiatric Services drawn from the records of 98,609 VA patients who were new to the remote method of care. The study found patients were about 24 percent less likely to require hospitalization in the six months after receiving remote care than they were in the six months preceding such care; the number of days such patients were hospitalized decreased by close to 27 percent. Meanwhile, patients who did not switch to remote care showed no difference in their rate of hospitalization.

Recent research from Northwestern University on phone-based therapy also found it just as effective as face-to-face sessions.

The rate of suicides among veterans reached its highest rate since the Sept. 11 attacks earlier this year and the agency has been criticized for downplaying the wait time for veterans to see a doctor or mental health professional.

A report by VA Office of the Inspector General in April found that 94,000 patients waited an average of 50 days, rather than two weeks, as previously reported. Old scheduling technology was blamed in part for the discrepancy.

In the announcement VA Secretary Eric Shinseki said veterans increasingly are communicating with the department's staff through online chats and text messages, which is being encouraged. "Shame keeps too many veterans from seeking help," Shinseki told a suicide-prevention conference, according to an article in Stars and Stripes. He added: "But we can't influence and help those we don't see," Stars and Stripes reports. 

In response to the increased demand for services, the VA is adding 1,600 mental health clinicians and nearly 300 support staff.

In addition to beefing up mental health services back home, the VA has some innovative methods in the works to aid deployed military personnel including counseling over smartphones and a "transportable telehealth unit"--a container rigged with webcams and other telehealth equipment to provide services with counselors miles away. Remote mental health services for dependents also are proving an important link in the counseling chain

To learn more:
- here's the VA's announcement
- read the Elsevier Global Medical News story
- here's the Psychiatric Services abstract
- here's the Stars and Stripes story

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