VA Office of Research and Development
Overview: Depression is common among Veterans. About 1 in 6 Veterans experiences depression at any given time, and about half may experience it during their lifetime. Without treatment, depression can contribute to substance use, poor health, suicide, and early death. However, many people delay or do not receive treatment. Fewer than one-third of Veterans with depression use psychotherapy. Although the VA is working to improve access to mental health care, staffing shortages can lead to long wait times. These waiting periods may provide an opportunity to support Veterans and help them prepare for treatment. Mental Health Link: The research team developed Mental Health Link (MHL), a text-based process that supports Veterans while they wait for mental health services. MHL helps patients better understand their emotions and symptoms and offers simple coping strategies they can use right away while waiting. Study Goals: The study will examine whether MHL helps Veterans during the wait period and with treatment engagement. The study will also ask Veterans and providers about what helps or prevents MHL from being used in routine care. Study Design: Over five years, the study will compare MHL with usual care at three VA sites. It will include 192 Veterans referred to psychotherapy for depression. The results will show whether MHL improves participation in treatment and helps Veterans while they wait for services. In the future, these findings may help the VA expand MHL and other effective mental health and suicide-prevention services.
Background: Depression is one of the most prevalent mental health concerns among Veterans. Nearly 1 in 6 Veterans has the disorder at any given time and 50% of Veterans meet criteria for depression at some point in their lives. Depression is associated with significant adverse outcomes, and untreated can result in drug abuse, poor health outcomes, suicide and other-cause mortality. Adults with depression often delay and underutilize treatment, and such delays in care are associated with low treatment utilization. Significance: Psychotherapy utilization rates for depression among Veterans over…
Inclusion Criteria: -Veterans who receive a referral to psychotherapy for depression in a specialty care clinic (i.e., Mental Health Clinic at the VA or through VA Community Care) Exclusion Criteria: * Have current suicidal ideation with intent of self-harm in the last week * Have current homicidal ideation with plans to hurt a specific person or have a clinical flag for disruptive behavior in their chart * Have visual impairment that will impact completion of self-reports * Have current diagnoses of bipolar disorders, psychotic disorders, memory and cognitive disorders * Have referrals onl…
Mental Health Link (MHL) is a text-based process that supports Veterans with depression while they wait to begin mental health care. Twice a week, it helps Veterans check in on daily events, emotions, and depression symptoms while offering brief, practical coping strategies based on evidence-based therapies, including cognitive behavioral therapy, behavioral activation, and acceptance and commitment therapy. MHL was tailored with input from Veterans to improve emotional awareness and monitor changes in symptoms.