MIRECC / CoE

Case management focuses on building a collaborative relationship between the therapist and the client to facilitate assessment, evaluation, care coordination, and advocacy on behalf of the client and addresses individual needs (Case Management Society of America, 2017). Intensive case management, or ICM, assists in coordination of care, which increases access. Additionally, ICM provides resources addressing social determinants of health and allows the case manager to provide streamlined and enhanced care to meet the Veteran's needs. Therefore, Transit and SUPERCEDE's version of ICM involves the assigning a case manager who ensures the Veteran establishes a continuity of holistic care and health care needs by connecting them to providers and services both within VA and in VA community care.

Transit - community organizations

Transit was a Transitional Care Program pilot that provided Veterans at risk for suicide and not eligible or engaged in VA healthcare services with brief psychotherapy and intensive case management services to address any pressing acute mental health needs and to support their connection to VA or community providers. The intervention concurrently supported at-risk Veterans' acute needs and their transition to more comprehensive VA or community-based resources, depending on their VA eligibility status. Veterans enrolled in TRANSIT received immediate and short-term psychotherapy to provide symptom relief, intensive case management and follow-up, a crisis response plan, as well as referrals to community mental health placement by the TRANSIT suicide prevention coordinator.

Supercede - VA/community care

Suicide Prevention intensive Case management and coordination in community care 2.0 - SUPERCEDE - This program tested the feasibility of a suicide prevention intensive case management (ICM) intervention to increase access to high quality mental health services for Veterans who are at risk for suicide. This intervention combined a modular version of Brief Cognitive Behavioral Therapy for Suicide Prevention (Bryan & Rudd, 2018) with intensive case management, and coordination of VA care and VA authorized community care. This intervention aimed to ensure Veterans at risk for suicide who were referred out to the community for physical health care services received timely access to specialty mental health care. This intervention focused on providing Veterans at-risk for suicide or who experienced severe mental health symptoms and experience psychosocial needs with resources to address risk factors known to contribute to suicidal ideation, such as unemployment or housing resources. Veterans enrolled in SUPERCEDE received immediate and short-term psychotherapy to provide symptom relief, intensive case management and follow-up, a crisis response plan, as well as referrals to community mental health placement by the SUPERCEDE suicide prevention coordinator.

VA PSCI-SPC Supercede Manual

Supercede-RCT - VA/community care

SUPERCEDE-RCT is a hybrid type 2 clinical trial further examining the feasibility and acceptability of SUPERCEDE.

The next steps of the SUPERCEDE intervention are to conduct a Randomized Controlled trial of the intervention. The trial will be conducted in 100 Veterans. SUPERCEDE will be compared to the current standard of VA care. This project is underway.