Improving Mental Health Care for Veterans is Vital

Nov 12, 2014, 9:00 AM, Posted by Ilse Wiechers

Ilse Wiechers, MD, MPP, MHS is associate director at the Northeast Program Evaluation Center in the Office of Mental Health Operations of the U.S. Department of Veterans Affairs and faculty with the Yale Geriatric Psychiatry Fellowship. She is an alumna of the Yale Robert Wood Johnson Foundation (RWJF)/VA Clinical Scholars Program (2012-2014).

Health and disease are on a continuum.  We are at a point in time where we are trying to understand the constituents of health, whereas historically our focus has been on understanding disease. It is important to recognize that veterans have unique determinants of health not shared with the rest of the population, such as exposure to combat and prolonged time spent away from social support networks during deployment.

These exposures can put veterans at increased risk for mental health problems, such as posttraumatic stress disorder, depression, and substance use problems. The U.S. Department of Veterans Affairs (VA) has a health care system uniquely positioned to help improve the overall health of veterans because of its expertise in addressing these unique mental health needs.

I have the privilege to serve our nation’s veterans through my work as a geriatric psychiatrist conducting program evaluation for the Office of Mental Health Operations (OMHO) at the VA. My work provides me an opportunity to directly participate in several of the key components of the comprehensive mental health services the VA provides for veterans.

The VA has made great efforts to integrate the delivery of mental health treatment into primary care settings. This is especially important for the older populations I treat, since we know older patients are less likely to obtain specialty mental health services and more likely to receive treatment in primary care settings. I see patients in one of the VA’s integrated primary care clinics and collaborate regularly with my patients’ primary care providers, nurses, social workers, case managers, and health psychologists, who are all part of the Patient Aligned Care Team.

Ensuring that all veterans in need have access to high quality, evidence-based, veteran-centered, and recovery-oriented mental health care is central to the work we do in OMHO. We assess and disseminate best practices; identify service gaps and provide technical assistance to address those gaps; develop informatics tools, reports and analyses to support the care being provided in the field; deploy new or revised clinical services; and develop effective communication practices across the many stakeholders within the VA system.  

In doing so, OMHO helps ensure quality and access across the system for the more than 1.3 million veterans with mental health problems. I work with colleagues who are experts in psychopharmacology, supported employment, family and couples services, epidemiology and public health, medical informatics, and clinical psychology, just to name a few.

VA Secretary Robert McDonald recently wrote that the VA is critical not only to veterans but to the entire American health care system.  I couldn’t agree more, and I believe the lessons learned from our work improving the mental health of veterans will be vital in shaping how we improve health of the whole person.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.