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Innovation in Treatment

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Dana Melching and Martha S. Waite

Dana Melching, MSW, LCSW (left) and Martha S. Waite, MSW, LCSW (right)

Thursday, September 13, 2012

GLA is at the forefront of many mental health treatment innovations. One such innovation in treatment delivery is the integration of mental health into the primary care setting.

The Sepulveda Ambulatory Care Center (SACC) was selected as a demonstration site for this advancement in patient care. As part of the project, teams of mental health providers are now imbedded into the primary care team. These mental health providers include staff from all four mental health disciplines including psychiatry, psychology, nursing and social work. Teams are using expanded and flexible scheduling and new options in communications to stay in close touch with patients and providers. Case management via the Translating Initiatives for Depression into Effective Solutions (TIDES) concept allows for both “curb-side” consultation and direct real time access to mental health. Barriers to mental health treatment are reduced and removed by this collocated and collaborative “warm handoff” between primary care doctors and mental health clinicians.

At the center of the integration of mental health and primary care services is the Veteran. Patient Aligned Care Teams (PACTs) surround our patients with a panel of staff who are dedicated to supporting Veterans in their self-directed care. At SACC, we have a "whole person orientation" that does not just spotlight the patient’s symptoms but rather focuses on the wellbeing of the entire person. All of this was made possible by an innovation that allows for same-day access to mental health care in primary care. In this model, patients are truly at the center of their own care.

PACT wants to welcome our newest addition to the Mental Health Integration (MHI) innovation team in primary care, Dana Melching, MSW, LCSW.  Melching has worked at the VA since 2007.  Melching says, "It's an exciting team to be a part of," adding "the access of mental health services to primary care patients results in treatment in a matter of minutes versus longer waits in the past.”  The integration model she is part of in primary care consists of an initial screening by a TIDES Care Manager, followed by Melching, the Psychologist, Psychology Interns, Psychiatrist or Psychiatry residents completing a Mental Health Initial Assessment.  Patients are then referred to TIDES care management, a myriad of evidence based groups including: coping with stress, stress management, and anger management.

The innovation team is moving forward in developing more opportunities for cutting edge treatment including integrating the Veteran's treatment plan with Mental Health and Primary Care involvement.