Introduction
The Veterans Health Administration (VHA) is the most extensive integrated health care system in the United States that provides high-quality wellness programs at thousands of medical facilities. Over 9 million Veterans who are enrolled in this specific Veterans Administration program receive high-rate treatment every day. According to the VHA’s website, its mission is to Honor America’s Veterans by providing exceptional health care that improves their health and well-being (2009).
American military veterans reportedly have higher rates of psychiatric disorders, lower socioeconomic status and worse physical shape than the civillians. They also show a higher statistic of suicide than the civilians do. The researchers prove that patients who receive the Integrated mental health care show more progress and improvement on the path of battling depression. Treatment within primary care settings results in greater adherence to treatment and improvements in depression symptoms compared to usual care. The Veterans health organization carries out many types of research to determine the best-integrated care practices to cure the mental state of the Veterans.
The purpose of the following study is to provide a thorough research on the influence of the practices conducted on mental health and to examine the overall effectiveness of the integrative care system in delivering specific treatment. This research will examine and discuss the primary studies about implemented integrated healthcare models as well as provide examples and designs of those above.
The sources covered in this paper are articles from various medical journals speculating about different programs which promote effective treatment of mental health problems. The documents also provide specific procedures for different mental disorders. Besides, this paper evaluates new programs that encourage the effective integrative therapies of common mental health and substance use disorders as well as their impact on the mental state of the veterans.
Review of Literature
History
The first initiation of the primary care mental health integration (PC-MHI) was in 2007 by the U.S. Department of Veterans Affairs. The program integrated mental health services into 94 primary care clinic. Their main goal was to bring more attention to mental illnesses and to encourage the medication of the most prevalent mental health conditions such as anxiety, depression, and substance abuse. The integrated methods used various specialists to provide the best experience possible for the patients who were getting experimental treatments. The effectiveness of collaborative, measurement-based approaches to integrated care is well established for various mental illnesses, especially for such disturbance as depression.
Methods and Results
There are various methods of Integrated mental health care specifically created for the veterans. The collaborative care models that the patients receive are always carefully researched and tested before they can start to be conducted in primary care. People who struggle with depression often find it extremely hard to discover an effective method of treatment. Moreover, it is twice as challenging for veterans, therefore VA launched a pilot program in which several dozen people took part. By the end of the program, patients who completed the full treatment have shown a significant decrease in the symptoms of depression.
Even after the re-evaluation in a few years, the results were still satisfactory (Wray, Ritchie, Oslin, & Beehler, 2018). An integrated model can be useful in a primary care population of veterans who are comorbid for anxiety and substance abuse. Veterans who finished the treatment provided by the mental health professionals within the integrative care program increased the number of continual visits to the psychological experts with a goal to improve their mental state.
Another innovative method of treatment is Integrated primary care (IPC), which is one of many implemented by VHA strategies that aim to make a more affordable access to the mental health treatments. IPC, is proved to successfully increases access to initial physocoligal evaluations and therapy in primary care. Its specific objective is to continue to engage in specialty mental health services, which also includes collaborative care and primary evaluation of their progress on their path to recovery.
With the help of this program, those patients who were not able to see the results from the brief treatments are now able to have access to a higher level of care, such as specialty mental health treatment. Moreover, collaborative care was a more effective method of implementing the Integrated primary care program. CC not only increases access to pharmacotherapy and care manager support but also improves depression, anxiety, and quality of life outcomes for primary care patients (Possemato, Shepardson, & Funderburk, 2018). Because of the high effectiveness, such a program has a high potential of decreasing mental health diseases for veterans in the future.
Besides, University of Arkansas for Medical Sciences partnered with the VA Center for Mental Healthcare to start an Implementation Facilitation (IF) program to evaluate effectiveness of an external/internal IF strategy within the context of a Department of Veterans Affairs mandate of Primary Care–Mental Health Integration (Kirchner, et al., 2014). The challenge of maintaining the balance of simultaneous implementation of new practices urged the researchers to develop a specialized program.
The primary supervisors of the IF strategy included a national external expert facilitator (NEEF) and an internal regional facilitator (IRF), who teamed up with providers and local, facility, and clinic managers to implement primary care-mental health integration (Kirchner, et al., 2014). At the end of the program, the outcome of the implied strategy was surprising to all. While it was expected that IF plan must have decreased mental health encounters by shifting care to PC-MHI, it turned out otherwise.
The program integration into primary healthcare have norticed a crusial increase in the veterans who primarily mental health treatment. Moreover, the study noted that patients who were involved in PC-MHI program significantly increased their visits to mental health specialty clinics. The reason behind it is because primary care-mental health integration show an escalation in the discovery of mental health disorders and decreases the avoidance of therapies.
This proves that the integrated health model actually works and becomes an effective treatment for veterans who struggle with mental illnesses. The reports also suggest that providing general mental health services in primary care should reduce delays in patients’ initiation of treatment, reduce the incidence of patients not showing up for appointments, and improve patient satisfaction with care (Johnson-Lawrence, et al., 2012).
Lastly, one of the most significant projects implemented by the Department of Veterans Affairs is the patient-centered medical home, which is termed the Patient Aligned Care Team (PACT). It is a transformational initiative whose primary focus is on integrational components of mental and behavioral health. The goal of the initiative is to completely redesign the work of primary care into interdisciplinary teams focused on increased access, and to actively incorporate collaborative expertise from specialists within primary care as well as provide first-rate to mental health treatment including alternatives to in-person care (Kearney, Post, Zeiss, Goldstein, & Dundon, 2011).
With these ambitious goals, PACT had a few principles that were strictly followed. Among them are offering team-based care, increasing care efficiency, providing access to the best specialists, maintaining excellent service at all times, and developing seamless coordination of care. Patient Aligned Care Team offers the best platform for the most effective improvement in mental health, including the most severe conditions of mental diseases.
Discussion
The programs, researches, and experiments implemented by the Veterans Health Administration show a significant effect on those who struggle with mental health illnesses. Their goal is to implement the integrative care programs to reduce the number of those who have mental health diseases and encourage others to reach out for help in case of any doubt or discomfort. It is reportedly proved by many types of research that Veterans who get treated by the integrated methods of primary care show significant improvements against their symptoms after a short period.
Case reports suggest that in order to reduce patients’ unwillingness or fear to seek professional help and increase their satisfaction and desire to receive a second-time treatment, primary care has to receive general mental health services. It was achieved in the locations where Integrated mental health care has also improved access to specialty mental health care and reduced referrals to separate specialty services (Johnson-Lawrence, et al., 2012).
It was discovered that older people were much more prompt to using mental health treatment in primary care services. Taking that to consideration, the primary goal for central care-mental health integration is to encourage as many people as possible: men and women of all ages who suffer from any mental illnesses to reach out and get specialized primary treatment. By the successful results of the many experimental program, patients can be entirely sure to receive the most effective and personalized treatment. The integrated programs appear to be much more effective.
They show that patients who decided to proceed with the longer-term medication within the PC-MHI program are less likely to be diagnosed with severe symptoms of various mental illnesses. Contrary to the patients who get treatment in specialty psychiatric clinics who get diagnosed with more severe mental illnesses such as schizophrenia, bipolar disorder, personality disorders, or substance dependencies regularly.
Conclusion
Nonetheless, the Veterans Administration’s experience of integrating mental health into primary care demonstrates that it is possible and quite practical. Moreover, the VA model provides a workable and hugely aspirational, the paradigm for other private and public sectors. Significant progress has already been made to achieve integrated mental health and primary care in many industries of medical areas.
Various implemented programs show innovative ways to treat mental illnesses. One of the main goals of all integrated health models in primary care is to encourage all Veterans to reach out for specialist help in order to gain a full picture of their mental state. It is proven that integrated health models show more progress when it comes to treating mental illnesses rather than the usual care. Veterans are more than other communities that are prompt to have mental illnesses; therefore, putting a focus on the integrated programs specifically for veterans is a great way to help them overcome severe diseases.
The Department of Veterans Affairs contributes millions of dollars to implement various researches, experiments, and programs to determine the best methods for curing common mental health problems that bother many heroes.
References
Johnson-Lawrence, V. D., Szymanski, B. R., Zivin, K., Mccarthy, J. F., Valenstein, M., & Pfeiffer, P. N. (2012). Primary Care–Mental Health Integration Programs in the Veterans Affairs Health System Serve a Different Patient Population Than Specialty Mental Health Clinics. The Primary Care Companion For CNS Disorders. Web.
Kearney, L. K., Post, E. P., Zeiss, A., Goldstein, M. G., & Dundon, M. (2011). The role of mental and behavioral health in the application of the patient-centered medical home in the Department of Veterans Affairs. Translational Behavioral Medicine, 1(4), 624–628. Web.
Kirchner, J. E., Ritchie, M. J., Pitcock, J. A., Parker, L. E., Curran, G. M., & Fortney, J. C. (2014). Outcomes of a Partnered Facilitation Strategy to Implement Primary Care–Mental Health. Journal of General Internal Medicine, 29(S4), 904–912. Web.
Possemato, K., Shepardson, R. L., & Funderburk, J. S. (2018). The Role of Integrated Primary Care in Increasing Access to Effective Psychotherapies in the Veterans Health Administration. Focus, 16(4), 384–392. Web.
Veterans Health Administration. (2009). Veterans Affairs. Web.
Wray, L. O., Ritchie, M. J., Oslin, D. W., & Beehler, G. P. (2018). Enhancing implementation of measurement-based mental health care in primary care: a mixed-methods randomized effectiveness evaluation of implementation facilitation. BMC Health Services Research, 18(1). Web.