Enhancing Access to Insomnia Care in VA PCMHI Clinics

Clinical and subthreshold insomnia together affect at least one third of Veterans and up to 44% of those seeking treatment in VA primary care clinics. Chronic insomnia detracts from many if not all facets of health and well-being and puts Veterans at risk for mental and physical health problems. The VA has led an impressive nationwide training program for its providers to learn how to do Cognitive Behavioral Therapy for Insomnia (CBT-I), the gold-standard treatment for chronic insomnia. However, there remain barriers to accessing CBT-I, and, when coupled with the sheer volume of Veterans needing insomnia treatment, clearly additional avenues for enhancing access to insomnia care are needed. A new study, Enhancing Access to Insomnia Care in VA PCMHI Clinics (EASI Care), is exploring a new way to do just this. One of the goals of EASI Care is to train Primary Care Mental Health Integration (PCMHI) staff in how to do Brief Behavioral Treatment for Insomnia (BBT-I). BBT-I was developed from CBT-I to be shorter and more flexible than CBT-I, yet still efficacious. In addition to training providers in BBT-I, this project will also test the effectiveness of a set of implementation strategies designed to boost the uptake, adoption, and sustainability of BBT-I delivery. The VAMHCS is one site in this multisite project led by Dr. Adam Bramoweth, a clinical psychologist and investigator at the VA Pittsburgh Health Care System. I am the site Principal Investigator at the VAMHCS; the other sites include the Durham VA Health Care System, the Minneapolis Veterans Affairs Medical Center, and the Corporal Michael J. Crescenz VA Medical Center. The project began in September 2020 and ends August 2024. Retrospective data from electronic medical records, qualitative interviews, and surveys will all help identify how best to introduce and sustain BBT-I for insomnia care for Veterans who need it!