MIRECC / CoE

SC MIRECC Core Update: Clinical Care with Dr. Jeffrey (Jeff) Cully

What makes your Core unique?

The South Central MIRECC (SC MIRECC) has a long history of improving mental health care for Veterans, especially those who are rural and underserved. The Clinical Care Core has played an important role in these innovations by facilitating local, regional, and national initiatives to improve access to high quality mental health care through two broad approaches – 1) partnerships and 2) mental health improvement programs and projects.

Major partners of the Clinical Care Core include the Consumer Advocacy Board (CAB – established in 2001) and the recently created Clinical Input Committee (CIC – established in 2024). These two entities ensure that the SC MIRECC has formal channels for SC MIRECC affiliates to obtain input from Veterans and VA clinicians about how best to align our work with the needs of “end users”.

The SC MIRECC is also investing in clinical demonstration and quality improvement projects. Specific projects include efforts to improve access to evidence-based psychotherapies, providing Veterans with resources to prevent suicide and accidental injury from firearms through a secure firearm storage kit (developed in collaboration with colleagues at the Alexandria VAMC and the VISN 16 suicide prevention office), and providing curricula and mentoring for the next generation of VA mental health clinicians to conduct quality improvement projects that directly impact clinical services.

The Clinical Care Core has played an important role in the overall mission of the SC MIRECC, and we anticipate the portfolio will expand in the coming years given VA’s increased focus on improving direct clinical services to Veterans. The Clinical Care Core will continue its focus on improving mental health care delivery with an explicit goal to foster collaborations across other SC MIRECC cores including research, education, and research training. The Clinical Care Core is committed to providing consultation and mentoring across the SC MIRECC and we encourage all members of the SC MIRECC community to reach out to our team for assistance or ideas as we continue to innovate to improve care for rural and underserved Veterans.

Q. What has your Core accomplished over the past year?

In collaboration with Ashley McDaniel (thanks Ashley!), we updated and expanded the Clinical Care Core website. On the page you will find details about our team and program, projects and training opportunities, and the CAB and CIC.

Over the past year the CIC has solidified itself as a VISN-wide resource and hosted multiple SC MIRECC affiliates who presented their clinical care project ideas. Meeting on a quarterly basis and being available for rapid “off cycle” consultation, we encourage our affiliates and staff to bring new ideas or existing projects to the CIC. Now in its 25th year, the CAB completed another year of providing valuable feedback on a host of SC MIRECC projects. Like the CIC, the CAB is a VISN-wide resource, and we encourage members of our SC MIRECC community to schedule an opportunity to obtain feedback on your research, education, or clinical care projects and ideas.

In terms of specific projects, the Clinical Care Core has now distributed over 7,000 Veteran-facing secure firearm storage kits through VA Suicide Prevention Coordinators (SPCs) and Community Engagement & Partnership Coordinators (CEPCs). These kits provide gun locks, empty chamber flags, and brief literature to encourage secure firearm storage for Veterans and Veteran families. They are also frequently requested with the SC MIRECC’s STORES materials which help Veterans and families discuss secure firearm storage. Notably, the secure firearm program has resulted in valuable collaborations with community partners (non-VA) as well as engaging Veteran rehabilitation programs in the product assembly process.

A second project, the MyBrief CBT program, is disseminating and supporting the delivery of a VA-developed brief cognitive behavioral therapy by training and supporting mental health clinicians across the nation. As of December 2025, 17 Veteran Integrated Service Networks (VISNs), 195 VA facilities, and over 400 clinicians have adopted the program. More importantly, almost 5,000 Veterans have received over 15,000 MyBrief CBT sessions. Outcomes for the program suggest high levels of clinician and Veteran satisfaction with notable improvements in Veteran depression outcomes.

Lastly, our Mentored Clinician Quality Improvement Program (MCQIP) completed its first cohort of training and mentoring frontline mental health providers. Clinicians from VISN 16 participated and received mentoring and grant funds to access paid online coursework to support their development. A second MCQIP cohort matriculated in October2025.

Q. What are your goals for the coming year?

The Clinical Care Core, and SC MIRECC, are committed to making improvements to access for mental health care in VA – especially for rural and other underserved populations. Our goal is to expand the number of investigators, educators, and clinicians working on improving access. These advancements can occur through collaborations within the SC MIRECC (e.g., cross-cutting efforts to assist past and current research and education projects), improved training and support for clinicians who are interested in quality improvement and expanding our funding for clinical demonstration and quality improvement projects. We are very encouraged by the recent success of SC MIRECC affiliates in obtaining clinical demonstration project funds from the VA’s Office of Rural Health and we hope to expand these projects and partnerships into the future. In the coming year, we are excited to help facilitate new partnerships in VISN 16 – especially at the facility-level where we believe there are “untapped” resources and collaborations with clinicians who are knowledgeable about the “real-world” challenges faced in the delivery of mental health care.

In collaboration with the SC MIRECC Research Core, we expect that clinical demonstration and quality improvements will be incorporated into the existing SC MIRECC pilot study program in the next fiscal year. This expansion hopes to increase collaborations between researchers and educators with frontline clinical staff by providing dedicated funding and resource mechanism to drive our shared interests.

Other programs such as the CAB and CIC will continue to be available as resources for MIRECC affiliates, and we encourage affiliates to reach out to our Clinical Core team to discuss and/or schedule a time to bring your projects to these committees. We anticipate recruitment for a 3rd cohort of the MCQIP. Lookout for a call for applications in the summer of 2026.

And finally, the secure firearm storage and MyBrief CBT program will continue into FY26. We are very excited about a new project that Dr. Derrecka Boykin and her team will be leading in collaborating with the SC MIRECC. Dr. Boykin will be implementing and developing methods to scale up the Courage Group program across VISNs 16 and 17. Courage group is a manualized psychotherapy designed to address sexual violence and military sexual trauma.

Q. Whom would you like to highlight for their service to your Core?

The scope and depth of the work occurring in the Clinical Care Core requires a team effort. I would like to call out special thanks to Darrell Zeno (administrator and lead coordinator), Mary Shapiro, PhD (CIC Lead), Jay Boffa, PhD (CAB Lead), and Kelley Arrendondo, PhD (Quality Improvement Training Lead) who have been instrumental in the development of our programming. Our team would like to thank the members of the CAB and the CIC for their passion and commitment to helping the SC MIRECC to stay focused on the most pressing issues facing our Veterans and the VA healthcare system.

Last updated: January 27, 2026