May is Mental Health Awareness Month and The Leadership Development Group (TLD Group) took an opportunity to interview Laura Marsh, MD, Executive Director, Mental Health Care Line for the Veteran Affairs Medical Center in Houston, TX. Dr. Marsh, a geriatric psychiatrist and a neuropsychiatrist whose background is in neurological conditions with psychiatric complications, is also Professor, Menninger Department of Psychiatry, Baylor College of Medicine in Houston.
In this blog, Dr. Marsh shares her recommendations for leaders looking to move the needle on mental health initiatives within their own communities. Below is a preview of the longer interview.
Can you provide your perspective on how COVID-19 has shifted the conversations around mental health, and what implications you believe this has for working in the mental health space?
Since 9/11, the Veteran population was the first to shine a light on mental health in terms of bringing a conversation around PTSD to our collective conscious. In the same way, COVID-19 has furthered the conversation about mental health and mental wellbeing for everyone. We are all suffering from much uncertainty and ambiguity. People are more anxious and depressed and substance use is at an all-time high. Unfortunately, we still have a system that is largely focused on crisis interventions. We don't have enough psychiatric beds in this country. We need to make sure mental health treatment is available to people who need it, and we still need to make sure that it's not only integrated but equitable.
What types of initiatives does the VA have in place to help support the mental health of the populations they serve?
The VA has a variety of initiatives to serve Veterans of all ages and eras, from 18 to 100+. An important accomplishment in 2008 was the Uniform Mental Health Services Act (UMHSA), which specifies exactly what mental health services VA hospitals and clinics are required to offer to Veterans and their families. The requirements differ according to the size and type of VA hospital or clinic, but they apply across the entire VA system. With the UMHSA, the VA, unlike any other healthcare system I know, spells out specific guidelines and principles for the care Veterans receive. Accordingly, we have initiatives for mental health care in primary care settings, couples, and family therapy, and for serious mental illnesses, substance use disorders, dementia, depression, etc. For any given condition, Veterans can also expect they will receive recovery-oriented and evidence-based psychosocial treatments and psychotherapies that were developed specifically for that condition.
The VA’s Veterans Justice Outreach (VJO) and suicide prevention and initiatives are models for the nation. Those programs are community-facing as well as integrated with our care programs. Our VJO program works with 8 Veterans treatment courts across our urban and rural catchment area and provides jail in-reach, helping to identify Veterans in jail who are in need of psychiatric treatment and that the lack of it is related to their criminal charges.
About Dr. Laura Marsh, MD
A geriatric neuropsychiatrist, Dr. Marsh's clinical and research expertise focuses on the recognition and treatment of psychiatric disturbances in patients with Parkinson’s disease. Since 2009, she has been the Executive Director of the Mental Health Service at the Michael E. DeBakey Veterans Affairs Medical Center. Previously, she was director and principal investigator of the Clinical Research Program of the NIH-funded Morris K. Udall Parkinson’s Disease Research Center at Johns Hopkins University School of Medicine. In addition to her efforts to improve psychiatric treatments for individuals with Parkinson's disease, a focus of her administrative role is to facilitate the general integration of psychiatric and mental health care into medical care and to promote positive attitudes and beliefs about mental health care and psychiatric illnesses. Dr. Marsh also serves on the scientific or clinical advisory boards or steering committee for the Houston Area Parkinson’s Society, the Houston/Harris County Coalition for the Homeless Continuum of Care, the American Parkinson’s Disease Association, and the National Parkinson Foundation. She is an active member of the American Association of Geriatric Psychiatry, the Parkinson’s Study Group, and the Movement Disorders Society and has published widely on psychiatric disorders in PD and related conditions, including as co-editor of the book, Psychiatric Issues in Parkinson’s Disease: A Practical Guide.