Wouldn’t It Be Nice?: An Integrated Health Care System


An Integrated Health Care System

By Pat De Leon, PhD, Former APA President

ID 34903714 © Alphaspirit | Dreamstime.com

ID 34903714 © Alphaspirit | Dreamstime.com

One of the most satisfying aspects of serving at the Uniformed Services University of the Health Sciences (USUHS) is realizing the extent to which APA, APS, various national nursing organizations, and individual psychology and nursing leaders have been willing to go “that extra mile” for those who are serving our nation and oftentimes putting themselves in “harm’s way.” Former APA Presidents Don Bersoff and Ron Fox have participated in our health policy seminar, as has APA President Barry Anton. Nadine Kaslow has addressed a larger psychology colloquium; while Give an Hour Founder and President Barbara Van Dahlen has graciously participated in both venues.

Global Approaches to Integrated Health Care: Translating Science and Best Practices into Patient-Centered Healthcare Delivery: This Fall, APA President Barry Anton graciously extended invitations to the USUHS community to participate in his two and one-half day working Summit. Over 400 viewers, representing 36 countries, “streamed live” into the conference; which was held at the APA Capitol View Conference Center. Video recordings of the summit sessions will soon be made available on the APA web. Dr. Anton’s goal was to facilitate the sharing of best practices and innovations across disciplines, health care professions, health care settings, and countries. Through the shared understanding of “patient-centered care” he envisions enhanced public expectations (and, in all candor given his long-time interest in the field, appetite) for the integration of health services, bringing together un-likeminded people and shareholders across the health care domain. On his visionary planning committee was former APA Congressional Science Fellow Brian Smedley and Toni Zeiss, former head of mental health for the Department of Veterans Affairs (VA), both of whom have participated in our health policy seminar. Two of the noteworthy keynote speakers were Ronalso Holer, MD, from the Pan American Health Organization (PAHO) and Sue Dopson, Ph.D. from the United Kingdom. APA President-elect Susan McDaniel also actively participated, moderating panels on special populations and international perspectives.

USUHS student-participant views: “The Summit brought together the pressing issues in healthcare integration. The attendees demonstrated well-rounded ideas and approaches to healthcare and service delivery. I learned about many new topics and ways to communicate. For example, the role of entrepreneurship and business management is becoming increasingly indispensable for any clinician. The experts expressed the pressing need of updating professional education with integrative science on what exactly ‘health,’ ‘wellness,’ ‘illness,’ and ‘patient-centered care’ mean from various disciplines. Lastly, the role of the patient in developing and implementing integrated care remains relatively untapped; e.g., training patients and family in health communication, using their consumer choices to influence the market, etc. [Edwin Szeto].”

“The Summit was an incredibly rewarding experience. While we often speak about the importance of integrated health care within the American healthcare system, it was eye-opening to hear from experts from around the globe who provided perspectives on the need for such efforts worldwide. Not only did we discuss the importance of getting out of our healthcare AND national silos, the conference put this into action by bringing together physicians, economists, nurse practitioners, psychologists, and many others who were national experts in the U.S., the U.K., Latin America, and other countries around the world. It was spectacular.… Absolutely amazing [Omni Cassidy].” Psychology’s future will remain very bright, as long as today’s leaders actively engage the next generation in their efforts and thereby share their vision.

Give an Hour: Also this Fall, Give an Hour celebrated its tenth anniversary having provided over 175,000 hours of free mental health care to our nation’s veterans, service members, and their families. The four-day Celebration of Service included a fireside chat at the Embassy of Canada, as well as a special benefit concert performed by Brian Wilson of the Beach Boys and Paul Dano who played Brian in the outstanding film Love and Mercy – in which a California psychologist was “less than ethical.” USUHS students and faculty were invited to attend the ceremonies. If one stays to the very end of the film, long after many in the audience have unfortunately departed, it becomes clear that director Bill Pohlad and Barbara are on a mission to Change the Direction of how our nation views mental health. Does each of us know “The Five Signs”? President and Michelle Obama have publicly talked about their importance.

As Barbara has often stated: “We must change our culture if we are to succeed in saving lives and ending suffering. We must come to accept that mental health and mental illness are elements of the human condition – just as physical health and disease are.” Today less than half of the veterans (23% to 40%) who are experiencing mental health problems are likely to seek professional mental health care for fear of stigma or other related barriers to care. Listening to those who have made a difference at the national level, it also becomes quite clear that sustainable change requires commitment at the local, individual-to-individual, level. At the fireside chat, it was noted that those who serve our nation develop a deep appreciation for the importance of building a community of effort and of seeking to contribute beyond oneself. It was opined that our nation needs our veterans to once again share their spirit of comradery and to bring home their “lessons learned” to our nation’s cities and rural communities. As these complex issues are being contemplated, it is particularly timely that Give an Hour announced that they are actively bringing research expertise into their ever-expanding community of partners. Changing a culture takes time and personal dedication.

Military Construction, Veterans Affairs, and Related Agencies (MilCon): The day before Veterans Day, the U.S. Senate passed the Fiscal Year 2016 MilCon/VA appropriations bill, recommending $1.0 billion above the President’s budget request, by a vote of 93 to 0. Addressing the special needs of certain veterans; e.g., the Veterans Justice Outreach (VJO) program, the Senate: “(C)ommends the Department for its efforts to support justice-involved veterans. According to the Bureau of Justice Statistics, 9.3 percent of people incarcerated in the United States are veterans; 70 percent of these veterans are incarcerated for a nonviolent offense. The Department reports that 60 percent of incarcerated veterans suffer from substance abuse, 30 percent from a serious mental illness, and 60 percent from a major medical condition. Almost 50 percent of homeless veterans have interacted with the criminal justice system. The Department’s VJO specialists provide outreach and case management services to justice-involved veterans to help avoid unnecessary criminalization of mental illness and substance abuse. VJOs also work directly with local law enforcement and court officials to help identify veteran-specific issues, including Post-Traumatic Stress Disorder [PTSD] and Traumatic Brain Injury [TBI], and they connect eligible veterans with VA treatment programs.”

“Women Veterans – The Committee believes VA must make better progress in addressing the needs of women veterans…. Access to and utilization of VA benefits and services by women veterans remain low, with women often encountering cultural roadblocks in a system that was largely designed to meet the needs of male veterans. The Committee anticipates the results of an ongoing system-wide review intended to determine what type and number of healthcare workers the system should have to address current and future demand of gender-specific care.” Changing a culture requires vision and dedication. “Wouldn’t it be nice?” Aloha,

Pat DeLeon, former APA President – HPA – December, 2015