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Expanding Access to Behavioral Health Services for Veterans and Their Families

  • By: NYSHealth
  • Date: April 2017
  • Priority Area: Veterans' Health
  • Type: Grant Outcome Reports
  • Category: Grant Outcome Report
  • Grantee Name: RAND Corporation

Overview

In New York State, rates of behavioral health problems among veterans deployed in Iraq and Afghanistan are high: nearly one out of four struggles with post-traumatic stress disorder and/or depression, and close to 40% have reported binge drinking. Family members, including children, also experience high rates of behavioral health concerns, such as depression and anxiety. Although nearly all veterans are eligible for medical and behavioral health care at the U.S. Department of Veterans Affairs (VA), there are considerable barriers to accessing these services that require veterans to navigate both private and public health services. To create a coordinated care model, the North Shore-Long Island Jewish Health System began a collaboration with the Northport Veterans Affairs Medical Center to create the Unified Behavioral Health Center for Military Veterans and Their Families (UBHC). This center uses a public-private model of care to provide behavioral health care for veterans and their families by co-locating and coordinating services across two independently governed sides. One side of the center is operated by the VA and serves veterans, whereas the other side is operated by a private-sector provider and primarily serves the families of veterans. In 2014, NYSHealth awarded RAND Corporation a grant to assess the impact of this partnership for expanding access to behavioral health services for veterans and their families.

Grantee: RAND Corporation

Dates: March 2014–February 2016

Grant Amount: $385,232

Grantee Website: http://www.rand.org

Grant ID: 13-02660


Outcomes, Lessons & Opportunities:

  • Identified key factors that led to the successful establishment of the UBHC center, including invested staff from both participating organizations, strong working relationship among staff, a grant that catalyzed its establishment, and media attention that helped raise awareness of its services;
  • Identified key implementation barriers, such as insufficient senior-level buy-in from the local VA, difficulty meeting the needs of both participating organizations during construction of the new facility, sustainability issues for the model, and a lack of institutionalized procedures for collaborative activities;
  • Analyzed service use for the center and found that although the VA and private provider sides of UBHC had different patterns of use, both succeeded in becoming operational and delivering a substantial amount of services in a short time frame;
  • Found improvements in clinical outcomes, including fewer behavioral health problems among child patients and, among adult patients, improvements in depression, post-traumatic stress disorder, family functioning, and quality of life;
  • Found overall patient satisfaction with care, particularly among family members who appreciated care providers who were knowledgeable about and sensitive to the experiences of veteran families; and
  • Produced an issue brief and full report documenting the implementation of UBHC and its delivery services and care outcomes: “The Unified Behavioral Health Center for Military Veterans and Their Families: Documenting Structure, Process, and Outcomes of Care.”

 

Based on the evaluation, RAND provided recommendations for UBHC to improve its services and for other providers that wish to learn from or replicate the model, including:

  • Formalize the role of a VA staff member to act as a liaison between the two sides of the clinic to integrate treatment plans, share access to patient records, and ensure strong communication between the two sides;
  • Create a physical environment that is both family-friendly and conducive to collaboration; and
  • Create a continuum of services, which would allow either side of the clinic to make referrals to other resources outside of UBHC’s scope of services (e.g., financial support, legal, and other family-related services).

 

Following the release of the report, NYSHealth hosted a public discussion, "Public-Private Partnerships: Behavioral Health Needs of Veterans & Families," in conjunction with the Mental Health Association of New York City, to share the findings.

Co-Funding and Additional Funds Leveraged: N/A