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BACKGROUND/RATIONALE:
Increasing numbers of veterans from the Operation Iraqi Freedom and Operation Enduring Freedom (OIF/OEF) are entering the VA system seeking care for depressive and or anxiety disorders. Medical centers are striving to provide mental health care for these veterans. However it is unclear how and to what extent this care is being delivered. Evidence-based treatment guidelines exist for these mental disorders. In order to develop interventions that implement evidence-based care for these disorders a better understanding of current structure of care is needed.
OBJECTIVE(S):
Enter text here.
METHODS:
Translating Initiatives for Depression into Effective Solutions (TIDES) is an example of a successful QUERI project. An initial important step in creating the TIDES intervention was the TIDES Manager Survey that interviewed VISN, primary care, and mental health site leaders about the structure of care delivery at their site. This successful survey provided valuable information on structure of care delivery that helped shape the TIDES intervention. This TIDES Manager Survey would be adapted for the OIF/OEF veteran population and would be implemented and analyzed using methods developed by the TIDES research team. Experts from the TIDES research team will serve as consultants. Four medical centers from each of three VISNs, 16, 19, and 20 will be chosen to include sites that have and have not received augmented funding for the OIF/OEF population, are both large and small, and operate in different geographic regions. Site mangers for mental health and primary care would be identified and recruited. The survey asks the respondent to identify: 1) the role of screening and the OIF/OEF clinical reminder; 2) site of care; 3) barriers and facilitators to care; 4) collaborative relationships; 5) outcome data collection; 6) opinions on core components of care; 7) clinical challenges for this population; 8) outreach efforts; 9) types of mental health diagnoses being made; 10) model of care being used.
FINDINGS/RESULTS:
No results at this time.
Data analysis of the quantitative section of the survey will conform to usual survey data analysis, specifically responses will be summarized, and frequency and mean response patterns to each question will examined. All summaries will consist of aggregated (at the site level) de-identified data. We do not plan to collect any data that could be tied to an individual patient or provider.
IMPACT:
Results from this project will better inform the structure of care and extent of employed evidenced-based treatment guidelines currently being delivered to treat the OIF/OEF veteran suffering from depressive and or anxiety disorders. These results will also be prepared as a manuscript for submission for peer-reviewed publication. This pilot data would be combined with lessons learned from the QUERI projects TIDES, WAVES, and ReTIDES to submit for funding to implement an evidence-based care intervention treating depression and or anxiety disorders in the OIF/OEF veteran. Results will also be combined with findings of Dr. Stecker's RRP concerning veteran-level barriers to access for OIF/OEF veterans suffering from mental disorders to inform intervention development.
PUBLICATIONS:
None at this time.
DRA:
Health Services and Systems, Mental Illness, Military and Environmental Exposures
DRE:
Treatment, Quality of Care
Keywords:
Access, Operation Enduring Freedom, Operation Iraqi Freedom
MeSH Terms:
none
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