Impact of a mental health trainee interdisciplinary program on a veteran population

BackgroundLess than half of adults with mental illness receive mental health services. Several barriers exist to accessing care including stigma and shortage of mental health clinicians. Due to the increasing demand for mental health services, the American health care system has begun moving toward an interprofessional approach. ObjectiveThe primary objective was to evaluate the impact of a trainee-led interprofessional mental health team on treatment outcomes. MethodsThis single-center, retrospective, observational analysis was conducted at a Veterans Affairs medical center from August 2013 through April 2019. Eligible patients were identified using the clinic roster and manual review was utilized to exclude patients based on defined criteria. Patient demographics, referral source, initial appointment date, enrollment status, psychiatric diagnoses, and mental health assessment measures were collected. The primary outcome was change in Patient Health Questionnaire (PHQ-9), General Anxiety Disorder-7 (GAD-7), and Post-Traumatic Stress Disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (PCL-5) total score from clinic intake to discharge. ResultsThere was a statistically significant reduction in PHQ-9 (-6.00; -38.54%; P < .001), GAD-7 (-4.35; -33.38%; P < .001), and PCL-5 (-19.33; -34.29%; P < .001) total scores. Additionally, there was a statistically significant change in PTSD remission rate per PCL-5 (+33.3%; P = .001). There was a numerical reduction in mental health-related emergency department visits (-3; P = .495), psychiatric hospitalizations (-7; P = .182), and psychiatric hospital days (-53; P = .229). ConclusionsA trainee-led interdisciplinary mental health team positively impacted depression, anxiety, and PTSD related outcomes in a Veteran population. Results support further study and incorporation of the interdisciplinary care model into outpatient mental health settings.