A top priority for the Veteran's Healthcare Administration is improving access to high-quality mental healthcare. Mobile and telemental healthcare are a vital component of increasing access for veterans. The Veteran's Healthcare Administration is making efforts to further broaden how veterans receive their care through VA Video Connect, which allows veterans to connect with their provider from their residence or workplace. In this mixed-methods study, successes and challenges associated with the rapid implementation of VA Video Connect telemental health appointments are examined through (1) administrative data and (2) qualitative interviews at one medical center. Within 1 year of the telehealth initiative, the number of providers experienced with telemental health increased from 15% to 85%, and telehealth appointments increased from 5376 to 14,210. Provider reported barriers included administrative challenges and concerns regarding care. Having an implementation model of telehealth champions and a team of experienced mental health providers allowed for rapid adoption of telehealth. Utilizing a similar model in other settings will further enable more veterans with depression and anxiety to have access to evidence-based psychotherapy, regardless of location or national crisis. With the dramatic increase in both training for providers as well as veteran use of telemental healthcare during the COVID-19 pandemic response, future research should aim to better understand which teams were able to switch to telehealth easily versus those which struggled, along with examining system-wide and provider-level factors that facilitated continued use of telehealth after social distancing requirements related to COVID-19 were relaxed. Keywords Access to care. Mental health. Technology. Telehealth. Veteran The demand for flexible mental health service delivery came to the forefront for healthcare industries across the globe this year as a result of COVID-19. Current projections estimate there could be as many as 1 billion telehealth appointments Electronic supplementary material The online version of this article (
A growing population of older adults receive treatment for depression but remain symptomatic. We report on a feasibility pilot study of an intervention (ACTIVATE) to improve depression care by encouraging the older person to take a step to intensify the existing treatment. Older adults (N=43) receiving home-meal service and in depression treatment, but still symptomatic, participated in the ACTIVATE intervention. Assessments were conducted to evaluate change in treatment. Many (66.6%) participants took a step to change their treatment; the rate (88.2%) was higher among individuals with major depression. ACTIVATE may be a useful social work intervention to improve depression care.
Prior literature indicates that insecure attachment styles (i.e., anxious or avoidant) and attention-deficit/hyperactivity disorder (ADHD) both have negative impacts on romantic relationships, but relatively little is known about how these factors interact among couples where one partner has ADHD and the other does not. One hundred and fifty-nine partners of adults with significant ADHD symptoms completed measures of their own attachment styles, their partner’s ADHD symptoms, and relationship quality. Anxious attachment was associated with lower romantic relationship quality, but avoidant attachment was associated with more positive relationship outcomes. Results also indicated that the negative effect of ADHD symptoms on romantic relationship quality may be exacerbated by a partner’s high level of anxious attachment. Though insecure attachment styles are generally thought to have a negative impact on romantic relationships, avoidant attachment was generally associated with more positive outcomes in this study. Several possible explanations based on theoretical support are included in the discussion along with clinical applications and future directions.
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