Shelley Varner-Perez on Integrated Mental Health

Transforming Chaplaincy welcomes guest commentator Shelly Varner Perez, MDiv, BCC, who is a Transforming Chaplaincy fellow and clinical staff chaplain in the Portland VA Health Care System. For this Idea in Brief, Varner Perez comments on Nieuwsma, et. al. (2017), “Implementing integrated mental health and chaplain care in a national quality improvement initiative,” Psychiatric Services 68, no. 12.

We thank Shelley for her insight today and encourage chaplains and researchers – even those not working directly with veterans or in mental health – to explore the article:

Intuitively, many chaplains and other health professionals know collaborating with colleagues can improve patient care. The study explored methods to improve patient care by integrating mental health with other services at VA and DoD. It utilized mixed methods research to gather information about current practices as well as areas for improvement. Through teams at 14 facilities who followed the Breakthrough Series learning collaborative model, quality improvement (QI) projects addressed six areas: screening, referrals, assessment, communication & documentation, cross-disciplinary training, and role clarification. The results offer important takeaways for chaplaincy care.

Efforts to improve collaboration between mental health and chaplaincy were effective and statistically significant, particularly so for mental health professionals. Specifically, improvements were demonstrated among mental health professionals in the following practices: using a routine process to identify patients who could benefit from chaplain services; regularly communicating with chaplains to improve patient care; and having a clear understanding of how the disciplines can collaborate. The most significant improvements were seen in having opportunities for joint training with chaplains and mental health professionals when appropriate (p=.001). The data demonstrated that areas where the most effort was expended saw the most improvement. Individual chaplain efforts to collaborate with mental health professionals prior to these interventions seemed to drive positive change, though the impact did not persist through staffing changes.

Some practical takeaways for chaplains: if you have positive relationships with mental health professionals in your facility, make an effort to formalize the collaboration with a policy document or care coordination agreement that implements lasting change beyond duty station changes or staffing changes. When hosting an education event, consider expanding it to include mental health professionals or, better yet, plan an education event that spans both disciplines and invite mental health professionals as co-presenters. Take time to dialogue with mental health colleagues about their referral practices and tools they use for screening for spiritual care concerns. These are some practices demonstrated to improve integration of mental health and chaplaincy as demonstrated in this study.