Improving Access to High-Quality Mental Health Care for Veterans: Proceedings of a Workshop (2023)
Chapter: Appendix A: Statement of Task
Appendix A
Statement of Task
At the request of the Department of Veterans Affairs (VA), the National Academies of Sciences, Engineering, and Medicine will organize and host an in-person, 1.5-day public workshop to explore the current landscape for mental health care services in the United States, including the use of telehealth services. Building on the 2018 NASEM report Evaluation of the Department of Veterans Affairs Mental Health Services, the workshop will consider ways to improve veterans’ timely access to high-quality care for mental health conditions. In particular, the workshop will consider internal and external best practices for three critical needs for mental health access (known as tripartite access in the VA): urgent/crisis access, engagement access, and sustained access. The workshop will feature invited presentations and panel discussions on topics that may include
- Use of open access scheduling for timely diagnosis and initiation of treatment and for follow-up care as needed;
- Patient engagement, with special focus on communities who are disproportionally undertreated, and robust, user-friendly online resources for service members;
- Access to a course of guideline-concordant treatment in appropriate time frames after engagement access (e.g., 16 weeks of evidence-based psychotherapy weekly for PTSD);
- Same day access availability as a standard of care, not just for urgent care needs;
- Use of integration of mental health services into medical settings to address timely care needs;
- Scheduling practices which enhance tripartite access implementation;
- Incorporation of telemental health services to expand tripartite access availability;
- The impact of federal and state policies and regulations for telehealth and mental health care, and barriers to delivery of care, such as prescriptions and telehealth;
- Direct out-of-pocket costs for patients and the role of insurance coverage for mental health care in community care settings;
- Coordination from crisis care access to engagement and sustained access for mental health treatment (e.g., use of the Veterans Crisis Line/988 services);
- Use of mobile applications and online training and treatments (e.g., Moving Forward, online CBT for Depression) and their use to expand access to interventions;
- Innovative programs to train a diverse mental health workforce (including paraprofessionals and “peer specialists”) and to expand access to treatment in the future; and
- Use of first call resolution (Same Day Access) VA vs. Community standards.
The planning committee will develop the agenda for the workshop sessions, select and invite speakers and discussants, and moderate the discussions. A proceedings of the presentations and discussions at the workshop will be prepared by a designated rapporteur in accordance with institutional guidelines.
