. 2022 Mar 29;37(Suppl 1):22–32. doi: 10.1007/s11606-021-07076-x

Table 4.

Initiatives Promoting Mental Health Among Older Veterans, OVET Feedback, and Impact 2018–2020

Initiatives (guest)	OVET feedback, response, and current status
Mental and behavioral health support for older Veterans in rehabilitation (T32 palliative care trainee) March 2019	• OVET feedback: Provided feedback on interview guide, especially language and ways to frame/ approach the topics of (previously untreated) mental health with Veterans in non-stigmatizing ways. • Response: Incorporated more emphasis on cognition as a component of mental health as a result of the OVET meeting. • Outcome: Investigator reported in October 2019, “I completed data collection with providers ... Initial findings helped develop a model of behavioral health in nursing homes ... The OVET group’s insight about attitudes toward behavioral health was spot on and addressed by the providers in my study.”
Connection between hearing health and dementia (Audiology Trainee) December 2019	• OVET feedback: OVET suggested a screening process in audiology; should include one or two simple questions for caregivers to assist in timely identification of cognitive impairment • Response: Initiated development of brief assessment to use in audiology, with resulting information informing timely referral to gero-psychologist for further evaluation • Outcome: Currently on hold due to COVID-19
Safety in Dementia caregiver decision aid to address access to firearms (GRECC clinical investigator) October 2019	• OVET feedback: Members noted that content related to decisions regarding firearm access/storage options was equally relevant to those with PTSD and TBI. Recommended expanding priority populations to reach with this information (i.e., not solely focus on safety in dementia). Some added that Depression, Bipolar and Stroke issues could also affect safety. • Response: Based on OVET suggestions, incorporated more language specific to firearm-related issues, namely information on third-party mediators, legal assistance, and information on how to safely transfer firearms to others for safe-keeping during a crisis. • Outcome: Clinical demonstration project to test decision aid’s acceptability among older Veterans and caregivers is being planned.
Programming to address social isolation among older adults during COVID-19 (Director, Outreach Programs, Multi-disciplinary Center on Aging) July 2020	• OVET feedback: Ideas featured in case example • Response: Feedback informed the initial programming of the Emotional and Mental Health in Older Adults during Challenging Times Fall and Winter webinar series (weekly one-hour webinars with recordings available) • Outcome: Mental Health Wellness series was tremendously successful, with 437 registered to attend these weekly sessions. A Spring 2021 was launched in March 2021.
PTSD and trauma-informed end-of-life care (T32 Palliative Care trainee) August 2020	• OVET feedback: Not enough providers ask about mental health. Providers do not use the information in medical record. Discussing mental health is facilitated by having a trusted relationship with provider. Canned (i.e., screening) questions often are asked out of context and by providers who may not have a relationship and who may be in a hurry. Patients want to feel seen, heard, understood. Patients have to self-advocate and be very assertive about having mental health care needs addressed. • Response: Use the term "unresolved issues" to invite or frame conversations about trauma, prior life adversity. Include caregivers in my future work in this area. “Really excellent discussion and many good points, but I don’t have the ability to address the system-level issues.” • Outcome: As a follow-up to this meeting, invited a VA psychologist and local recovery coordinator to meet with the team. Conversation focused on ways to improve access to mental health services including disseminating information through veteran service organizations.

Initiatives (guest)

OVET feedback, response, and current status

Mental and behavioral health support for older Veterans in rehabilitation (T32 palliative care trainee)

March 2019

• OVET feedback: Provided feedback on interview guide, especially language and ways to frame/ approach the topics of (previously untreated) mental health with Veterans in non-stigmatizing ways.

• Response: Incorporated more emphasis on cognition as a component of mental health as a result of the OVET meeting.

• Outcome: Investigator reported in October 2019, “I completed data collection with providers ... Initial findings helped develop a model of behavioral health in nursing homes ... The OVET group’s insight about attitudes toward behavioral health was spot on and addressed by the providers in my study.”

Connection between hearing health and dementia (Audiology Trainee)

December 2019

• OVET feedback: OVET suggested a screening process in audiology; should include one or two simple questions for caregivers to assist in timely identification of cognitive impairment

• Response: Initiated development of brief assessment to use in audiology, with resulting information informing timely referral to gero-psychologist for further evaluation

• Outcome: Currently on hold due to COVID-19

Safety in Dementia caregiver decision aid to address access to firearms

(GRECC clinical investigator)

October 2019

• OVET feedback: Members noted that content related to decisions regarding firearm access/storage options was equally relevant to those with PTSD and TBI. Recommended expanding priority populations to reach with this information (i.e., not solely focus on safety in dementia). Some added that Depression, Bipolar and Stroke issues could also affect safety.

• Response: Based on OVET suggestions, incorporated more language specific to firearm-related issues, namely information on third-party mediators, legal assistance, and information on how to safely transfer firearms to others for safe-keeping during a crisis.

• Outcome: Clinical demonstration project to test decision aid’s acceptability among older Veterans and caregivers is being planned.

Programming to address social isolation among older adults during COVID-19 (Director, Outreach Programs, Multi-disciplinary Center on Aging)

July 2020

• OVET feedback: Ideas featured in case example

• Response: Feedback informed the initial programming of the Emotional and Mental Health in Older Adults during Challenging Times Fall and Winter webinar series (weekly one-hour webinars with recordings available)

• Outcome: Mental Health Wellness series was tremendously successful, with 437 registered to attend these weekly sessions. A Spring 2021 was launched in March 2021.

PTSD and trauma-informed end-of-life care (T32 Palliative Care trainee)

August 2020

• OVET feedback: Not enough providers ask about mental health. Providers do not use the information in medical record. Discussing mental health is facilitated by having a trusted relationship with provider. Canned (i.e., screening) questions often are asked out of context and by providers who may not have a relationship and who may be in a hurry. Patients want to feel seen, heard, understood. Patients have to self-advocate and be very assertive about having mental health care needs addressed.

• Response: Use the term "unresolved issues" to invite or frame conversations about trauma, prior life adversity. Include caregivers in my future work in this area. “Really excellent discussion and many good points, but I don’t have the ability to address the system-level issues.”

• Outcome: As a follow-up to this meeting, invited a VA psychologist and local recovery coordinator to meet with the team. Conversation focused on ways to improve access to mental health services including disseminating information through veteran service organizations.