The comorbidity of obsessive compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) is common and leads to worse clinical and psychosocial outcomes than PTSD alone. Yet, OCD remains underdiagnosed and undertreated among veterans, a population with high rates of PTSD. This qualitative descriptive study aimed to understand Veterans Affairs providers' current practices for assessing and treating OCD in veterans with PTSD, as well as barriers to and needs for assessment and treatment. Twelve clinical psychologists were recruited to participate in semistructured interviews. The qualitative interview guide and analysis were informed by the consolidated framework for implementation research. Rapid, matrix, and team-based qualitative techniques were used to facilitate analysis. Psychologists across general mental health clinics (n = 7) and a trauma-focused specialty clinic (n = 5) were interviewed. Findings revealed most psychologists in general mental health clinics had assessed for and treated OCD in veterans with PTSD. Yet, across clinics, providers held misconceptions about OCD diagnosis and treatment. Providers reported barriers to assessment and treatment including a perceived lack of knowledge and training, access to consultation and resources, and time. Trauma-focused specialty clinic providers also noted national mandates as a barrier to OCD assessment and treatment in veterans with PTSD. Providers identified needs including time for and access to education, training, consultation, and resources. Findings from this study detail current practices and strategies to facilitate assessment and treatment of OCD in PTSD. Addressing current barriers and needs would increase accessibility of services and potentially improve the lives of thousands of veterans at Veterans Affairs. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Telehealth can facilitate continuity of behavioral health treatment for opioid use disorder (OUD). Use of telehealth significantly changed during COVID-19, but it is unknown how implementation differed across payors nationally. Adults with OUD and a behavioral health treatment claim for OUD between January 2019 and February 2020, separated by commercial (N = 23,048), Medicaid (N = 87,303), or Veterans Health Administration (N = 84,597), were included. We performed descriptive analysis using longitudinal claims and electronic health record data from 2019 to 2021 and logistic regressions to evaluate associations between patient characteristics and utilization of telehealth visits in the pandemic period. Prior to the pandemic, 0.26%, 1.16%, and 2.67% of adults covered by commercial, Medicaid, or Veterans Health Administration had a telebehavioral health visit each month, respectively. Between April 2020 and March 2021, these averages increased to 12.7%, 18.8%, and 15.8%, respectively. Rates of in-person treatment dropped at pandemic onset but remained the primary modality. Age, sex, health plan type, co-occurring conditions, and comorbidity were all associated with telehealth use, and these variables differed between payors. Although in-person care for OUD decreased dramatically postpandemic onset, it remained the primary modality for adults with OUD. Despite swift increases in the rate of telehealth care, it was not widely adopted for OUD treatment and uptake differed significantly across payors and patient demographics (e.g., older individuals and veterans). Telehealth was used less for medication management overall, despite regulatory exceptions expanding on this option, also with notable differences across payors. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Broadband personality measures, such as the Minnesota Multiphasic Personality Inventory (MMPI) family of instruments, are commonly used as diagnostic aids within the Veterans Affairs (VA) health care system. However, research on how military experiences (i.e., era of service and combat exposure) affect scores on these measures has yielded mixed findings regarding both the magnitude and pattern of symptom profiles. Additionally, concerns remain about the generalizability of these findings, as many studies have drawn samples from similar treatment settings, such as VA PTSD Clinical Teams. Conclusions reached by this line of research vary in how clinicians should integrate past experiences into expected response patterns. This study continues this line of work by providing the first comparison of service era differences in a nonposttraumatic stress disorder-focused VA sample undergoing a variety of assessment-related referrals. We examine differences on the MMPI-2-Restructured Form while controlling for known demographic influences (i.e., sex and service connection). Participants (ntotal sample = 356) were compared for elevation rates on the content-based validity scales, and then, after excluding invalid protocols, we computed differences across the substantive scales using an analysis of covariance design. Despite the validity scale multivariate differences evident only on infrequent psychopathology responses and only on substantive scales substance abuse and disconstraint-revised, broader between-era contrasts suggest a similarity in Vietnam and Gulf veterans in their symptom experience, which may have implications for treatment planning and organizational expectations in the coming years. Results support the notion that demographic factors are critical to understanding service era influence and contextualizing their magnitude effectively. Clinical practice and research implications are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Electronic health record (EHR) flags alert staff within the Veteran Health Administration (VHA) to patients at high suicide risk for the purpose of enhancing their care. VHA implemented patient record flags category I-high risk for suicide (HRS-PRFs) in 2008, yet little is known about provider perceptions. In non-VHA settings, some EHR flags and alerts are perceived unfavorably by providers. This mixed methods quality improvement study examined perspectives of VHA mental health clinicians and suicide prevention coordinators (SPCs) regarding the perceived utility and drawbacks of HRS-PRFs. We conducted a national survey of SPCs (N = 286; February-March 2022) and semistructured qualitative interviews (January-July 2022) with a separate sample of SPCs (n = 5) and mental health clinicians (n = 20) with recent HRS-PRF experience. Providers reported satisfaction with HRS-PRFs and believed that they identify at-risk veterans and facilitate engagement in care. Survey and interview findings highlighted differences between SPCs and mental health clinicians regarding negative perceptions of HRS-PRFs. In the survey, one in five SPCs were dissatisfied with the administrative burden of delivering caring contacts, a required evidence-based suicide prevention intervention mailed for a year following flag inactivation. In the interview findings, some clinicians expressed concerns about unintended consequences on therapeutic rapport and stigma. Additional evaluation is warranted to assess veterans' experiences and clinical effectiveness outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Mental health has gained tremendous interest among researchers during the outbreak of the pandemic in 2020. Various programs for mindfulness and resilience training have also been introduced in response to help people cope with stress and adversity, both in clinical and nonclinical settings. Yet, their interplay remains underexplored in Vietnam. This study aimed to investigate the mindfulness-resilience relationship among university students. Undergraduates (N = 490) from various universities in Ho Chi Minh City, Vietnam, participated in a survey in which they reported the level of their mindfulness in everyday situations and how they recover from stress and difficulties. The Five Facet Mindfulness Questionnaire-Short Form and the Brief Resilience Scale were used as research instruments for the present study. The results revealed that (a) mindfulness and resilience showed a strong positive correlation, indicating that students with higher mindfulness also tended to report greater resilience (r = .89); (b) regression analysis demonstrated that mindfulness significantly predicted resilience, even after accounting for other variables (R² = .788); and (c) among the five facets of mindfulness, observation, description, nonreactivity, and nonjudgmental inner experience were significant predictors of resilience (p < .001), while aware actions was not (p = .264). These findings address a research gap in Vietnam, offering insights for culturally relevant mental health interventions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The involvement of peer support specialists in behavioral health crisis response is growing. While their roles in warm lines, crisis-receiving, and respite centers have been studied, their participation in mobile crisis teams remains underexplored. This review identifies the contexts and strategies for implementing peer support within mobile crisis teams to inform broader adoption. Following Arksey and O'Malley's methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, we searched MEDLINE, CINAHL, EMBASE, and APA PsycInfo, Sociological Abstracts, and Scopus through October 21, 2024. No peer-reviewed articles met the inclusion criteria. A gray literature search on October 28, 2024, using a web-based search engine, yielded 16 sources, which were extracted and assessed for quality. Using the Consolidated Framework for Implementation Research, we deductively coded all source documents by domain and inductively identified thematic patterns. Implementation strategies were also mapped to the Expert Recommendations for Implementing Change framework. Consolidated Framework for Implementation Research themes indicate that significant policy and local government initiatives facilitate innovation adoption within the outer setting. The lived experience of peers, their strong partnership ties, and the flexibility of incorporating peers are key innovation characteristics. Successful implementation depends on inner setting factors such as leadership alignment with policy, prioritization of recovery-oriented approaches, and resource allocation that fosters collaboration and accountability. Within the individual domains, team members must recognize the value and contributions of peers. Effective implementation may be compromised without strategic planning, early stakeholder engagement, and the development of transparent, accountable resources. Recognizing these determinants is essential for effectively prioritizing resources and advancing peer support in mobile crisis teams. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

In late 2018, the U.S. Department of Veterans Affairs (VA) implemented the Suicide Prevention in Emergency Department (SPED; 116th U.S. Congress, 2020; VA, 2018) initiative to protect veteran lives and promote follow-up with mental health services. SPED mandated the use of safety planning, a suicide prevention intervention, for those assessed as at-risk of suicide in emergency departments. To assess implementation and potential SPED benefits, we extracted from medical records an archival sample (N = 14,743) of patients' first VA emergency department visit between October 1, 2018, and May 13, 2023, in which they were screened as at-risk of suicide and evaluated a subgroup of these patients who discharged to home (n = 7,024). Overall, implementation of the risk assessment triggering the SPED requirements and safety planning intervention administration was high with room for improvement. Exploratory logistic regressions revealed safety planning was associated with 26% reduced odds of all-cause mortality (i.e., death from any cause, including suicide-specific and nonsuicide-specific causes) within 1 year but was not associated with increased 30-day mental health encounter attendance. Suicide mortality was not examined as an outcome. Findings suggest safety planning may be relevant to a broader range of patients assessed as at-risk in VA emergency departments than initially targeted. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This study examines whether aeromedical officer (AMO) training enhances outcomes for Navy and Marine Corps aviation personnel. The conceptual approach of this research is grounded in the literature on the importance of cultural competence in military mental health services; thus, this study hypothesizes that AMO-trained providers yield better outcomes than nontrained providers. Utilizing a sample of 501 waiver requests for personnel diagnosed with mental health conditions, we compared waiver approval rates and career impacts between those evaluated by AMO-trained and nontrained providers. Results from a binary logic regression indicated that individuals assessed by AMO-trained providers were 2.1 times more likely to be granted waivers, thus reducing the chance of career disruption, as well as reducing operational costs and loss of mission-ready personnel. Additionally, AMOs facilitated a more seamless waiver process, avoiding unnecessary delays in obtaining a waiver. Findings suggest that AMO training significantly improves service delivery by enhancing providers' cultural competence, leading to more favorable outcomes for both individuals and commands, underscoring the need for specialized training in mental health services. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Training and consultation in cognitive behavioral therapy for nightmares (CBT-N) were introduced for Veterans Health Administration (VHA) providers to reduce the frequency and severity of nightmares and improve functioning of veterans experiencing chronic nightmares. This study aimed to evaluate providers' sustained delivery of CBT-N and their perceptions of benefits and barriers to implementation to improve the successful adoption and long-term use of CBT-N throughout the VHA. VHA providers (N = 100) who completed the CBT-N training program at least 6 months prior to the study were sent an online survey about their continued use, feedback, and perceptions of CBT-N. The survey received a 65% response rate. Overall, perceptions of CBT-N were favorable. Ninety-five percent of providers reported continued delivery of CBT-N since completing the training program, with 100% of responders intending to use CBT-N in the future. Among CBT-N users, treatment was perceived to reduce nightmare frequency and/or severity and improve other domains of functioning (i.e., sleep health, trauma symptoms, quality of life). A third of the CBT-N users denied any barriers to using CBT-N. Primary barriers to use were related to providers' facility inner setting (e.g., unable to accommodate required session length or frequency, veteran population not appropriate for CBT-N) or veteran factors (e.g., schedule constraints, patient decision in shared decision making). Results encourage ongoing CBT-N training initiatives within the VHA. Directly tracking veteran outcomes and identifying necessary modifications to adapt CBT-N within the constraints of the inner setting, while preserving treatment integrity, are warranted to ensure and promote intervention effectiveness. (PsycInfo Database Record (c) 2025 APA, all rights reserved).