Veterans Health Administration Mental Health Program ...

Veterans Health Administration Mental Health Program Evaluation

Capstone Report

Katherine E. Watkins, Harold Alan Pincus

Sponsored by the U.S. Department of Veterans Affairs

H E A LT H

The research described in this report was sponsored by the U.S. Department of Veterans Affairs and was conducted by Altarum Institute and RAND Health, a division of the RAND Corporation.

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Program Evaluation of VHA Mental Health Services

Capstone Report

Authors:

Katherine E. Watkins

Brad Smith

Susan M. Paddock

Thomas E. Mannle, Jr.

Abigail Woodroffe

Jacob Solomon

Melony Sorbero

Carrie Farmer

Kimberly Hepner

David M. Adamson

Lanna Forrest

Catherine Call

Harold Alan Pincus

Program Evaluation of VHA Mental Health Services: Capstone Report

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PREFACE

U.S. policymakers and medical professionals increasingly recognize that quality mental health care is a key contributor to better, healthier lives for veterans with mental illness, and that setting measurable goals, promoting evidence-based processes of care, and monitoring performance plays a vital role in improving healthcare delivery and, ultimately, patient outcomes. In 2004, responding to the U.S. government's New Freedom Commission on Mental Health (2002), the U.S Department of Veterans Affairs (VA) finalized a 5-year Mental Health Strategic Plan (MHSP), which emphasizes mental health as an important part of veterans' overall health. Major goals contained in the MHSP include raising awareness of the importance of mental health, eliminating disparities in services, increasing early mental health screening, assessments, and referrals to care, and providing high-quality, evidence-based care.

In 2006, to assess progress toward MHSP goals, the VA commissioned RAND and the Altarum Institute to conduct an independent evaluation of the quality of the VA's mental health care system. The request was pursuant to the Government Performance and Results Act, which requires executive branch agencies to evaluate their programs, and was in keeping with the VA's commitment to ensuring to providing the best care to U.S. veterans.

The RAND/Altarum team conducted the study between August 2006 and November 2010. The evaluation represents the most comprehensive evaluation of a mental health care system ever undertaken. The evaluation focused on the quality of care delivered to veterans with one or more of five mental health or substance abuse diagnoses: (1) schizophrenia; (2) bipolar disorder; (3) posttraumatic stress disorder (PTSD); (4) major depressive disorder; (5) substance use disorder (SUD).

The evaluation's results should be of interest to policymakers in the areas of national defense and veterans' affairs, to mental health professionals, and to veterans and other audiences interested in veterans' health issues.

This research was conducted within the RAND/University of Pittsburgh Health Institute under subcontract to the Altarum Institute. The research was sponsored by the United States Department of Veterans Affairs.

A profile of RAND Health, abstracts of its publications, and ordering information can be found at health.

Program Evaluation of VHA Mental Health Services: Capstone Report

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ACKNOWLEDGEMENTS

The authors would like to thank the following who contributed to the production of this report. Our Steering Committee: Antonette Zeiss, Daniel Kivlahan, Robert Gresen, Kathy Henderson, Stanlie Daniels, Lynnette Nilan, Gregory Hinrichsen, Ira Katz, and Anita Lord Barbara Stephens, the Contracting Officer Technical Representative Our RAND Corporation quality reviewers Katherine Hoggatt, Greer Sullivan, and Paul Shekelle Katherine Gechter, Marcela Horvitz-Lennon, Robyn Gerdes, Leah Caldarone, and Teryn Maddox for their work on the contract James Torr and Lynn Polite for the work on editing, proofreading, and formatting the report

Program Evaluation of VHA Mental Health Services: Capstone Report

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