Michael E. DeBakey VA Medical Center - Houston, Texas
Tele-mental Health: Makes it Easier to Get Care
Veterans who have a computer, smart phone, or tablet now have access to mental health services from the Michael E. Debakey VA Medical Center. It’s tele-mental health, and it’s helped nearly 1,000 Houston-area Veterans get the care they need.
Tele-mental health uses the app VA Video Connect, a secure connection between the Veteran and provider. So long as the provider knows where the Veteran is—in case of emergency—it can be used anywhere.
Air Force Veteran Christopher Banks said he prefers therapy in the comfort of his own home.
"It is actually easier than coming into the facility,” Banks said. “I can be in my own home, which helps me with sharing. Plus, it’s much better because I don’t have to deal with traffic.”
This technology is perfect for Veterans who live far away, have medical problems, or find it difficult to leave the house.
“Often, coming to the clinic is a big burden for our Veterans,” said Dr. Jan Lindsay, psychologist. “Barriers include child care, traffic, parking, taking off work, or feeling anxiety when leaving their homes to come for treatment.”
With tele-mental health services those barriers can be eliminated. Houston VAMC is a leader in this field, with growth over the past 4 years nearly 7 times VA’s national average.
Banks, who has trouble walking, often cancelled his mental health appointments. And fighting traffic did nothing to help when he did show up to his appointment.
“I’d get so stressed from the drive that I would spend 90 percent of my therapy talking about why I’m so angry,” he said.
“This is a major benefit for those with mobility issues,” said Dr. Kaki York, deputy clinical executive, Mental Health Care Line. “We have Vets with ALS or Parkinson’s or who have had a stroke, for whatever reason cannot get here to continue treatment. Also, family therapy services—have you ever tried to coordinate an entire family? It’s very difficult. Video allows them to get in the same place at the same time instead of getting all of them to the VA.”
This technology also will allow for more consistency in treatment in Veterans whose jobs require them to relocate.
“Houston has a lot of oil field workers who live here for part of the time but somewhere else the other time,” said York. “They’re here for three months, then travel for six months. If they have internet connection, we are here for them.”
It’s up to the Veteran how much he or she uses video services. Patients have the option to combine in-person visits with video ones. They just need to discuss this with their providers.
“If you like coming into the clinic to see your provider, you can continue to do so and only use video telehealth when convenient,” said Lindsay. “We are trying to be more flexible in our approach to delivering mental health care and meet Veterans where they live to increase access to care.”
Houston has 75 mental health providers who are equipped to provide video connect services. Providers have reported that Veterans love this as an option, said Lindsay.
“When we provide psychotherapy via telehealth, some Veterans report that being at home makes it easier to focus on the work being done and acquire the skills they need to engage their lives more fully,” she said. “They feel safer at home.”
Also, providers have said that it provides unique insight into Veterans’ experiences. Providers are given access to the patients’ homes. Many times, when asked what medications they are taking, Veterans may forget. With this technology, they just walk into the bathroom and show the provider their medicine cabinets.
According to Banks, another advantage is that items the therapist recommends he read are right at his fingertips.
“When I was with the providers, they would recommend different links or health guides and I had to wait to get home to pull it up,” he said. “With telehealth it’s right there. We can be in a chat and I can copy and paste or pin it to the search bar. It makes it easier, especially when they recommend a book. If you aren’t a person who takes pen and paper to session, you’d never remember that when you got home. Memory is not the most reliable, especially with some of us Vets. At home, I can open a search bar and go straight to it.”
Veterans interested in VA Video Connect for mental health services need to speak with their providers and have a mobile device and internet connection. Resources are available for the duration of treatment for those Veterans who lack the proper set-up.
“Our goal would be any mental health clinician at the main facility to provide telehealth services when the patient wants it and provider thinks it would be helpful,” said York. “We are not quite 100% there yet, but we are getting close.”