eScreening Facilitates Mental Health Assessment
A research team led by Niloo Afari, PhD, and James Pittman, LCSW, at the VA Center of Excellence for Stress and Mental Health (CESAMH), has developed and tested a new web-based, mental health screening process for Veterans. Results of the study show it facilitates mental health screening and documentation of results for new Veterans enrolling in the system. Using web-based screening with tablets, eScreening automatically evaluates and integrates screening results of posttraumatic stress disorder, depression, general anxiety, traumatic brain injury, military sexual trauma, substance abuse, pain, and other symptoms into a Veteran’s medical record. It also provides clinical reminders and clinical-note documentation and immediately generates customized, patient-centered reports and education materials for Veterans. “eScreening improves mental health screening and documentation and reduces related costs, and Veterans love using the technology,” said Pittman. When the new system was compared with traditional paper screening, Veterans who completed eScreening were significantly more satisfied than those who underwent paper screening. Although eScreening took about five minutes longer for Veterans to complete, it reduced clinician documentation time by an average of 17 minutes. It also resulted in a significantly greater percentage of completed clinical reminders, 99-100% compared with 89%-93%. Overall, eScreening was more efficient, reducing clinician burden and redundant screening. It also increased access to screening and timely referral to appropriate services without requiring more staff. eScreening is currently available only in the San Diego VA Medical Center, but the CESAMH and VA Center of Innovation are developing an enhanced version, expected to be available at multiple VA sites. For more information, contact Dr. Afari at Niloofar.Afari@va.gov. or James Pittman at James.Pittman@va.gov.
Evaluation of Web-Based Training for Veteran-Centered Brief Family Consultation
Web-based training for mental health clinicians in Veteran-Centered Brief Family Consultation (VCBFC) will be assessed in a randomized, controlled trial of 90 clinicians at six VA facilities. Although VA has mandated that all VA medical centers and very large community-based outpatient clinics provide VCBFC to Veterans with serious mental illness, training efforts related to VCBFC have been very limited. The standard training strategy of an in-person workshop is impractical in training large numbers of clinicians in the intervention. If shown to be effective, the web-based training, developed by Dr. Noosha Niv in the VISN 22 MIRECC, would be a more practical approach to training large numbers of clinicians. The study will assess the effectiveness of web-based training by comparing it to in-person training and to a control (no-training) condition. It will compare the effects of the three training conditions on knowledge of the intervention, skill in applying the intervention, use of the VCBFC following training, and attitudes about family involvement. “If the web training is effective, it will allow us to rapidly train a large number of mental health clinicians and, hopefully, increase family involvement in mental health care,” said Dr. Niv. “A number of benefits are associated with increased family involvement, including increased patient satisfaction, longer stays in treatment, better medication adherence, and improvements in recovery attitudes, such as hope, knowledge and empowerment.” For more information, contact Noosha Niv, PhD, at firstname.lastname@example.org.
My Medications: A New Tool for Veterans
A new tool for medication self-management, My Medications, will soon be available in MyHeatheVet, the VA’s online, secure patient portal. Developed by the VISN 3 MIRECC and the Mental Health Executive Committee of MyHeatheVet, My Medications will provide a comprehensive medication list that Veterans can share with their prescribers and providers. Medications can be downloaded from VA’s electronic medical records (CPRS) and are accompanied by pictures of the medication (when available). Veterans can enter medications from non-VA and over-the-counter sources as well. The system contains information about how medications are prescribed and can also include how Veterans actually take the medication as well as unwanted side effects they may experience. A number of tools will allow Veterans to monitor and improve how they take their medications and monitor the positive and negative effects of medications over time. Although all information in MyHeatheVet is private, Veterans can print out the lists and monitoring forms and share them with their treatment providers. This should improve communication between Veterans and their treatment providers and lead to better and more accurate treatment decisions received by Veterans, if it is effective in easing transition challenges for returning Veterans, and whether it should be more broadly disseminated.