Mental Health Services
Office of Mental Health Services
The Office of Mental Health Services is the national program office that sets program and policy guidance for mental health services provided throughout VHA.
The Office of Mental Health Services aims to insure that all veterans have access to needed mental health care. VA Mental Health advances the principle that mental health care is an essential component of overall health care and promote mental health recovery. The internet site is intended to serve veterans, their family members, mental health clinicians, VA staff, affiliated mental health associations and the community, providing information about mental health conditions and services.
Mental Health Services site
Centers of Excellence
The Centers of Excellence were established by Congress in 2006 with the goal of researching the causes and treatments of mental disorders and using the dissemination of education to put new knowledge into routine clinical practice in the VA. There are currently three OMHS Centers of Excellence which are funded by Mental Health Enhancement Initiative processes. These Centers will migrate to OMHS budgeted funding effective FY10.
Each COE has a focus (e.g., mental health disorders and delivery of best practices treatment) and theme (e.g., determining risk and resilience factors of PTSD; delivery of PTSD care/treatment; and suicide prevention) under the larger COE mission. In general, the COEs have research, clinical improvement, educational and training, bioethics and security information, and business process programs to deliver these services.
Community Homelessness Assessment, Local Education and Networking Groups (CHALENG)
Project CHALENG (Community Homelessness Assessment, Local Education and Networking Groups) for Veterans, an innovative program designed to enhance the continuum of care for homeless Veterans provided by the local VA and its surrounding community service agencies.
Project CHALENG site
Community Living Center (CLC)
The Community Living Center (CLC) Mental Health Program provides for the integration of mental health services in the CLC setting. This program provides guidance and oversight for the integration of mental health providers in VA CLC. The CLC Mental Health Provider provides assessment, treatment, and team-focused services, with an emphasis on promoting psychosocial behavior management services and culture transformation in VA CLCs.
Health Care for Homeless Veterans (HCHV)
- The Health Care for Homeless Veterans (HCHV) Program: conducts outreach to identify homeless Veterans who are eligible for VA healthcare and assist these Veterans in accessing appropriate levels of care. In addition, HCHV also contracts with community-based programs to provide residential treatment for homeless Veterans.Health Care Information for Veterans site
- The Homeless and Residential Rehabilitation and Treatment Programs: offer a wide array of special programs and initiatives specifically designed to help homeless veterans live as self-sufficiently and independently as possible. Recognizing that the vast majority of homeless veterans suffer from serious medical and mental illnesses, including substance use disorders, VA's clinical staff in medical centers across the country provide direct health care services to homeless veterans. VA's homeless-specific programs constitute the largest integrated network of homeless treatment and assistance services in the country. Homeless Veterans site
- The Veterans Justice Outreach (VJO) Program: provides timely access to VA services for eligible justice-involved Veterans to avoid unnecessary criminalization and incarceration of Veteran offenders with mental illness. This is done through direct outreach to Veterans in contact with the justice system through encounters with police, jails, and courts. Veterans Justice Outreach (VJO) Program site
- The Healthcare Reentry Veterans (HCRV) Program: promotes successful community integration of reentry Veterans by conducting outreach to vulnerable Veterans, while they are incarcerated, to engage them in treatment and rehabilitation programs that will assist in preventing their homelessness, readjusting to community life, and desisting from commission of new crimes or parole or probation violations. Healthcare Reentry Veterans (HCRV) Program site
- The Grant and Per Diem (GPD) Program: assists eligible entities in establishing new community-based programs to furnish outreach, supportive services, and transitional housing to homeless Veterans. The goal is to create and help maintain supportive housing and services centers in partnership with non-profit organizations or state and local government agencies to assist homeless Veterans and their families. Grant and Per Diem (GPD) Program site
Home-Based Primary Care (HBPC)
The Home-Based Primary Care (HBPC) Mental Health Program provides for the integration of a full range of mental health services on each VA HBPC team. Each HBPC team has a full-time HBPC Mental Health Provider who serves as a core member of the team, providing evidence-based cognitive and psychological assessment, psychological intervention services, and services for family caregivers of HBPC patients to promote the well-being and management of Veterans in their homes.
Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH)
The Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) Program combines VHA case management with permanent supportive housing (though HUD "Housing Choice" Vouchers) to address the needs of Veterans and their families who are homeless. The program is recovery based and is a key strategy in VA efforts to end homelessness among Veterans. Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) Program site
Mental Health Intensive Case Management (MHICM)
This is an intensive interdisciplinary team approach to the management and treatment of Veterans with SMI in the community and coordinated with a range of VA and community services. The hallmarks of the program include very frequent contacts between the staff and Veteran, a flexible approach with most contacts occurring in the community, a focus on rehabilitation, and a clear pathway of responsibility with a minimum of one year of continuous involvement.
Mental Health Rehabilitation and Residential Treatment Program (MHRRTP)
The Mental Health Rehabilitation and Residential Treatment Program (MHRRTP) provides state-of-the-art, high-quality residential rehabilitation and treatment services for Veterans with multiple and severe medical conditions, mental illness, addiction, or psychosocial deficits. The MH RRTP identifies and addresses goals of rehabilitation, recovery, health maintenance, improved quality of life, and community integration in addition to specific treatment of medical conditions, mental illnesses, addictive disorders, and homelessness. Homeless Programs site
Mental Illness Research, Education and Clinical Centers (MIRECC)
The Mental Illness Research, Education and Clinical Centers (MIRECC) were established by Congress with the goal of researching the causes and treatments of mental disorders and using education to quickly put new knowledge into routine clinical practice in the VA. There are currently 10 MIRECCs.
Each MIRECC has a different focus (e.g., a clinical disorder, improve functioning) and approach (e.g., genetics, health services) under the larger MIRECC mission. In general, the MIRECCs have research programs, clinical improvement programs, and educational and training programs. MIRECC site
- New England MIRECC - VISN 1
- Dual Diagnosis: veterans with mental illness in combination with addiction problems
- Center for Integrated Healthcare - VISN 2
- Integrating mental health services into the primary care setting
- Center of Excellence for Suicide Prevention - VISN 2
- Reduce the morbidity and mortality in Veterans due to suicidal behavior
- VISN 3 MIRECC
- The focus is on maximizing recovery for veterans with Serious Mental Illnesses (SMI)
- VISN 4 MIRECC
- Focus on co-morbidity—the co-occurrence of mental health disorders with either general medical, mental health, and/or substance use disorders.
- VA Capitol Health Care Network MIRECC - VISN 5
- Improve the care of all Veterans with schizophrenia and other Serious Mental Illnesses
- Mid-Atlantic MIRECC - VISN 6
- Overarching goal is the clinical assessment and treatment of post-deployment mental illness and related problems
- South Central MIRECC - VISN 16
- Improve access to evidence-based practices in rural and other under-served populations
- VISN 17 Center of Excellence (COE) for Research on Returning War Veterans
- Focus on mental health issues in returning war Veterans (OEF/OIF/OND)
- Rocky Mountain Network MIRECC - VISN 19
- To study suicide with the goal of reducing suicide in the veteran population
- Northwest MIRECC - VISN 20
- Applies genetic, neurobiologic and clinical trial methods to the discovery of effective treatments for major mental disorders
- Sierra Pacific MIRECC - VISN 21
- To improve the clinical care for veterans with dementias and with PTSD
- Desert Pacific MIRECC - VISN 22
- To improve the outcome of patients with chronic psychotic mental disorders (schizophrenia, schizoaffective disorder and psychotic mood disorders)
- VISN 22 Center of Excellence for Stress and Mental Health - CESAMH
- To be a national resource for cutting-edge understanding and state-of-the-art treatment of stress- and trauma-related problems
Primary Care - Mental Health Integrated Care Program
The Primary Care-Mental Health Integration Program advances VHA progress in providing primary care patients with availability of integrated services.
Primary Care-Mental Health Integrated Care Program provides evidence-based mental health care, either on site or remotely, in primary care settings. They are designed to:
- Promote effective treatment of common mental health conditions in the primary care environment (depression, problem drinking, anxiety, PTSD screening)
- Integrate care for physical and mental health in one setting
- Allow mental health specialists to focus on patients with more severe illnesses
- Promote patient engagement and adherence
- Avoid stigmatization and fragmentation of care
- Decrease risk of suicide attempts and deaths
Primary Care - Mental Health Integrated Care Program site
Psychosocial Rehabilitation and Recovery
VA has defined recovery as a journey of healing and transformation enabling Veterans with a mental health condition to live a meaningful life in their community of choice while striving to achieve their full potential. In order to support the rehabilitation and recovery of every Veteran with a mental illness, VA has identified recovery as a guiding principle for its entire mental health service delivery system.
Mental Health Recovery site
- The Local Recovery Coordinator: at each VAMC advocates for the recovery of all Veterans with mental illness, especially those with a serious mental illness and ensures access to and coordination of recovery oriented services. The LRC provides education and support to Veterans, family members, and VA staff members about mental illness and recovery and works to remove any barriers and stigma associated with mental illness.
- Psychosocial Rehabilitation and Recovery Services: Peer Support technicians - are individuals trained to help others with serious mental illness identify and achieve specific life and recovery goals. Many current peer support providers are OIF/OEF Veterans.
They assist Veterans with goal setting, problem solving, symptom management skills using a variety of recovery tools. They aim to empower Veterans by helping them identify their strengths, supports, resources, and skills. They advocate on behalf of Veterans in order to eliminate the stigma of mental illness. They identify social supports in the community that promote the integration of Veterans with mental illness into their local communities, and encourage the further expansion of local community resources. While accomplishing these tasks, peer support technicians create the vital element of hope in the Veterans they serve.
- Peer Counseling: All VAMCs and very large VA clinics must provide counseling from peer support technicians for veterans treated for SMI when this service is clinically indicated and included in the treatment plan. Peer Support technicians serve as role models to Veterans by sharing their personal recovery experiences while they teach and demonstrate skills that facilitate recovery.
- Psychosocial Rehabilitation and Recovery Center (PRRC): A PRRC is a transitional educational center that inspires and assists Veterans to reclaim their lives by instilling hope, validating strengths, teaching skills, and facilitating community integration so Veterans can attain meaningful self-determined roles in the community. A PRRC offers an array of services five days a week for veterans with SMI and significant functional impairment. PRRC site
- Psychosocial Rehab and Recovery:Family Outreach--Partnering with families, with the Veteran's consent is an essential component to VA mental health services. Research consistently demonstrates that Veterans with mental health disorders experience improved outcomes when families are active participants in their clinical care. Family services may include consultation, professional counseling, marriage and family counseling, training/education and mental health services as needed in connection with the Veteran's treatment plan.
Consistent with a recovery philosophy, flexibility is a key principle when involving families in care. Services must be tailored to the Veteran's phase of illness, symptom level, self-sufficiency, family cancellation, and preferences. A graduated continuum of services are necessary to meet these varied needs and range from engaging the family, to family education and facilitating access to the treatment team, to family involvement in treatment planning, to ongoing, low intensity, problem-focused family consultation, to intensive marriage and family counseling/therapy.
- Psychosocial Rehabilitation and Recovery Services: Veterans Mental Health Council (VMHC): is a group of Veteran mental health consumers, Veteran family members and other relevant stakeholders who provide input into VA mental health services. At least one VA staff acts as a liaison to the VMHC, to assist the Council and facilitate communication between the VMHC and local VA MH leadership. VMHC's facilitate Veteran input, provide a vehicle for sharing information between Veterans and the local VA, promote greater understanding of and collaboration with Veterans and VA and promote understanding and use of VA MH services by all Veteran and their families.
VMHCs form a positive working relationship with the local VA Medical Center, forming a true partnership and engaging in open dialogue with VA, for the continued improvement of VA mental health services. VMHC's can assist the local VA with many projects such as assistance with MIAW, Stand downs, outreach to vulnerable Veteran populations (homeless, OEF/OIF) and many others.
- CWT Transitional and Supported Employment: utilize work-based treatment to facilitate and strengthen vocational rehabilitation potential and to provide a continuum of employment support services including: vocational assistance, job skill development, job placement, and supportive job follow-up services.
- Transitional Work Experience (TWE) and Supported Employment (SE): Each VAMC must offer TWE and SE services for veterans who have occupational dysfunction resulting from a mental health condition or a co-occurring physical disability including SMI and who would benefit from this program. Transitional Work Experience (TWE) and Supported Employment (SE) site
Posttraumatic Stress Disorder (PTSD)
The PTSD Section coordinates PTSD clinical programs across the VA system in collaboration with other program offices such as Readjustment Counseling Service and the Poly Trauma section of Rehabilitation Service.
The National Center for PTSD (NCPTSD) was created in 1989 within the Department of Veterans Affairs in response to a Congressional mandate (PL 98-528) to address the needs of veterans with military-related posttraumatic stress disorder.
NCPTSD supports the clinical care and social welfare of America's veterans through research, education, and training in the science, diagnosis, and treatment of PTSD and stress-related disorders.
Services for Returning Veterans-Mental Health (SeRV-MH) teams, also known as Mental Health Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) teams, have been established across the VA system since 2005. These programs focus on early identification and management of stress related disorders and may decrease the long term disease burden on returning troops. Since Fiscal Year (FY) 2005, 93 SeRV-MH Teams have been established across the VA system. PTSD site
Services for Returning Veterans-Mental Health (SeRV-MH)
Services for Returning Veterans-Mental Health (SeRV-MH) teams, also known as Mental Health Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) teams, have been established across the VA system since 2005. These programs focus on early identification and management of stress related disorders and may decrease the long term disease burden on returning troops. Since Fiscal Year (FY) 2005, 93 SeRV-MH Teams have been established across the VA system. Services for Returning Veterans-Mental Health (SeRV-MH) site
Substance Use Disorders
VHA's Substance Use Disorders program is to provides effective, safe, and compassionate treatment to Veterans with substance use disorders. Substance Use Disorder care may be offered in specific clinics or in primary health care or mental health services.
VA facilities screen for alcohol problems at least annually and for other drug problems on an as-indicated basis. Treatment includes medical detoxification and stabilization, intensive outpatient rehabilitation, residential treatment with a substance use disorder track, medications to assist recovery, and care integrated with Primary Care and other specialty needs including PTSD. Psychosocial and other proven treatments are available. Substance Use Disorders site
The Suicide Prevention Program is based on the premise that ready access to high quality mental health services as well as programs designed to address suicide directly is important. A "knowledge bank" has been developed and designed to provide information about VA Mental Health services, access to the Suicide Prevention Hotline, and on-line access to a VA counselor via Veterans Chat.
Suicide Prevention Teams at each VA facility and largest Community Based Clinics provide access services as well as monitor and track high risk patients in order to assure that an enhanced level of care will be provided. Both the VA Suicide Prevention Hotline and Veterans Chat provide immediate access to a VA counselor and referrals to local sites for care. Suicide Prevention site
VA Evidence-Based Psychotherapy Training Programs
VA Evidence-Based Psychotherapy Training Programs - VA is strongly committed to making state-of-the-art, evidence-based psychological treatments widely available to veterans. To stimulate efforts to make these treatments widely available throughout VHA, the Office of Mental Health Services has developed national initiatives to train VA mental health staff in the delivery of evidence-based psychotherapies for PTSD, depression, and serious mental illness, which are actively underway.
The Local Evidence-Based Psychotherapy Coordinator supports the local implementation and sustainability of evidence-based psychotherapies. Each medical center has a designated Local Evidence-Based Psychotherapy Coordinator who serves as a champion for EBPs at the local level, providing clinical support and education and promoting local systems and administrative structures to facilitate the implementation of EBPs on the ground.
VA Training for College and University Staff
- Provides university and college campus counseling staff with information about unique challenges that veterans face in adjusting to college after deployment in war
- Provides information about common mental health issues for veteran students and how to link them up with resources to help with coping and adjustment to the college experience
VA Training for College and University Staff site