Mental Health Leadership Perspectives on the Value of a National Virtual Contingency Staffing Program in the Veterans...

Temporary mental health (MH) staffing gaps are common and may compound access challenges due to increasing demand for MH care combined with a shrinking MH workforce. In 2019, the Veterans Health Administration (VA) implemented a system of 18 regionally based Clinical Resource Hubs (CRHs) staffed with remote providers delivering virtual MH care. While the program demonstrated promise during early implementation for effectively addressing some access challenges, its sustainment may depend partly on leaders' perceptions of its ability to meet and adapt to access-related priorities. Our aim was to explore and describe how VA regional MH leadership identified and weighed values of the CRH during early implementation, and how it might have functioned beyond filling temporary staffing gaps. We conducted semi-structured interviews with CRH MH leaders (n = 36) across all 18 VA administrative regions. We analyzed data using a rapid qualitative approach that included templated summaries and matrix analysis. Three key perceived values of the CRH were identified: (1) its potential to offer a more integrated care experience than community (VA-purchased) care in some cases, (2) its ability to provide specialized MH services (e.g., suicide prevention) to rural areas and, (3) its capacity to improve MH provider recruitment and satisfaction. Virtual care delivered through the CRH can be a flexible option for maintaining access to MH services during staffing shortages. MH leaders' perspectives suggest the CRH program is not only a contingency staffing solution to access problems, but provides additional values that could be leveraged to improve MH care services more generally.