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Collaborating Across the Departments of Veterans Affairs and Defense to Integrate Mental Health and Chaplaincy Services

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ABSTRACT

BACKGROUND

Recognizing that clergy and spiritual care providers are a key part of mental health care systems, the Department of Veterans Affairs (VA) and Department of Defense (DoD) jointly examined chaplains’ current and potential roles in caring for veterans and service members with mental health needs.

OBJECTIVE

Our aim was to evaluate the intersection of chaplain and mental health care practices in VA and DoD in order to determine if improvement is needed, and if so, to develop actionable recommendations as indicated by evaluation findings.

DESIGN

A 38-member multidisciplinary task group partnered with researchers in designing, implementing, and interpreting a mixed methods study that included: 1) a quantitative survey of VA and DoD chaplains; and 2) qualitative interviews with mental health providers and chaplains.

PARTICIPANTS

Quantitative: the survey included all full-time VA chaplains and all active duty military chaplains (n = 2,163 completed of 3,464 invited; 62 % response rate). Qualitative: a total of 291 interviews were conducted with mental health providers and chaplains during site visits to 33 VA and DoD facilities.

MAIN MEASURES

Quantitative: the online survey assessed intersections between chaplaincy and mental health care and took an average of 37 min to complete. Qualitative: the interviews assessed current integration of mental health and chaplain services and took an average of 1 h to complete.

KEY RESULTS

When included on interdisciplinary mental health care teams, chaplains feel understood and valued (82.8–100 % of chaplains indicated this, depending on the team). However, findings from the survey and site visits suggest that integration of services is often lacking and can be improved.

CONCLUSIONS

Closely coordinating with a multidisciplinary task group in conducting a mixed method evaluation of chaplain-mental health integration in VA and DoD helped to ensure that researchers assessed relevant domains and that findings could be rapidly translated into actionable recommendations.

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Acknowledgements

Contributors

We would like to thank the VA/DoD Chaplains' Roles Task Group, which in addition to the authors included John Paul Allen, Ph.D., MPA; David Ballantyne, DMin, BCC, AAMFT; Robert M. Bray, Ph.D.; Theodore L. Bleck-Doran, DMin, BCC, AAMFT; Michael Carter, MRE; Carla Cherry, MDiv, ThM, BCC; Susan Cross, DMin; Kent D. Drescher, Ph.D., MDiv; Will Kinnaird, DMin, MDiv; John Milewski, MDiv, KCHS; Thomas Mills, MDiv; Michael Pollitt, DMin, BCC, CADC; Marion Thullbery, Ph.D., MDiv; Commander Kim Donahue, CHC, USN; Colonel David Graetz, CHC, ARNG; Lt Colonel Abdul R. Muhammad Sr., CHC, USA; Lt Colonel Kim Norwood, CHC, USA; Captain Shelia O'Mara, CHC, USN; Lt Colonel Michael Reynolds, CHC, ANG; Major Steven Richardson, CH, USAF; Captain Jessie Tate, CHC, USN; Ms. Renee Tribbett; Major Abner Valenzuela, CH, USAF; Major Kleet Barclay, CH, USAF; Lt Colonel Robert Wichman, CHC, USA; Penny Brierley-Bowers, Ph.D.; Jennifer Clarke, Ph.D.; George Fitchett, Ph.D., DMin; George Handzo, MDiv, BCC; and Glen Milstein, Ph.D. We additionally appreciate the data analysis assistance provided by Tarik Abdel-Monem, Amy S. Jeffreys, and Maren K. Olsen. Finally, we would like to thank all the additional VA and DoD personnel who contributed to the completion of this project.

Funders

Funding support provided by Department of Veterans Affairs and Department of Defense Integrated Mental Health Strategy (VA/DoD IMHS) and the VA/DoD Joint Incentive Fund.

Conflict of Interest

The authors declared that they have no conflict of interest

Author information

Authors and Affiliations

  1. Mental Health and Chaplaincy, Department of Veterans Affairs, Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA

    Jason A. Nieuwsma Ph.D., William C. Cantrell MDiv & Keith G. Meador MD ThM MPH

  2. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA

    Jason A. Nieuwsma Ph.D.

  3. Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA

    George L. Jackson Ph.D. MHA

  4. Division of General Internal Medicine, Duke University Medical Center, Durham, NC, USA

    George L. Jackson Ph.D. MHA

  5. Public Policy Center, University of Nebraska, Lincoln, NE, USA

    Mark B. DeKraai JD Ph.D. & Denise J. Bulling Ph.D.

  6. Marine Forces Reserve, Chaplain Corps, United States Navy, New Orleans, LA, USA

    William C. Cantrell MDiv

  7. Psychological Health Promotion, Deployment Health Clinical Center, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, Silver Spring, MD, USA

    Jeffrey E. Rhodes DMin & Mark J. Bates Ph.D.

  8. Department of Veterans Affairs, National Chaplain Center, Hampton, VA, USA

    Keith Ethridge ,MDiv

  9. RTI International, Research Triangle Park, Durham, NC, USA

    Marian E. Lane Ph.D.

  10. Department of Veterans Affairs, Mental Health Services, Washington, DC, USA

    Wendy N. Tenhula Ph.D.

  11. Booz Allen Hamilton, Washington, DC, USA

    Sonja V. Batten Ph.D.

  12. Departments of Psychiatry and Health Policy, Center for Biomedical Ethics and Society, & Graduate Department of Religion, Vanderbilt University, Nashville, TN, USA

    Keith G. Meador MD ThM MPH

Authors
  1. Jason A. Nieuwsma Ph.D.
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  2. George L. Jackson Ph.D. MHA
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  3. Mark B. DeKraai JD Ph.D.
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  4. Denise J. Bulling Ph.D.
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  5. William C. Cantrell MDiv
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  6. Jeffrey E. Rhodes DMin
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  7. Mark J. Bates Ph.D.
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  8. Keith Ethridge ,MDiv
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  9. Marian E. Lane Ph.D.
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  10. Wendy N. Tenhula Ph.D.
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  11. Sonja V. Batten Ph.D.
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  12. Keith G. Meador MD ThM MPH
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Corresponding author

Correspondence to Jason A. Nieuwsma Ph.D..

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Nieuwsma, J.A., Jackson, G.L., DeKraai, M.B. et al. Collaborating Across the Departments of Veterans Affairs and Defense to Integrate Mental Health and Chaplaincy Services. J GEN INTERN MED 29 (Suppl 4), 885–894 (2014). https://doi.org/10.1007/s11606-014-3032-5

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  • DOI: https://doi.org/10.1007/s11606-014-3032-5

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