by Candi Helseth
In rural areas where resilience and independence are admirable qualities and everyone knows everyone’s business, veterans with mental health issues resist seeking treatment. One solution is to co-locate mental health and primary care services, which, according to a 2010 study from the Milbank Memorial Fund, can be more effective because “the location is familiar and nonstigmatizing for patients.”
The VA’s Clovis Community Based Outpatient Clinic in Clovis, NM, realized that advantage after it co-located its primary care and mental health services under one roof in 2003. The Clovis VA Clinic, which serves eight New Mexico and five West Texas counties, developed a treatment model that encourages collaboration and integration of services between psychiatry and primary medical care.
In addition to reduced stigma, co-location has resulted in more efficient coordination of care among providers and improved convenience for veterans, said Richard Dane Holt, a clinic therapist. Veterans can coordinate appointments, which requires less travel in an area where driving distances alone may require four to five hours out of the day.
“When mental health concerns are of an urgent nature, the patient is seen the same day,” Holt said. “Non-urgent cases are usually seen within a week.”
Stigma is reduced because veterans don’t have to enter a facility marked as a psychiatric or mental health unit. Primary care providers (PCP) quietly refer patients for mental health services in the same building. Once a veteran reaches a moderate level of stability under the care of a behavioral health professional, the PCP resumes care coordination and ongoing treatment. Mental health providers are immediately available for consultation as needed.
Post-traumatic stress disorder (PTSD), depression, anxiety and substance abuse disorders have been the most common mental health diagnoses for veterans, Holt said. Using CPT (cognitive processing therapy) techniques, Holt has also successfully treated PTSD in veterans that experienced military sexual trauma, a term the Department of Veterans Affairs uses to refer to sexual assault or repeated, threatening sexual harassment that occurred while a veteran was in the military. Since Holt began using CPT in 2007, 40 veterans who were treated all reported reduced symptoms.
Back to: Winter 2012 Issue