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Vital Signs

VA mental-health portal is first of its kind

By Jennifer Durgin

Pomerantz, with one of the portals.

Veterans in rural areas who need mental-health care often must drive several hours to the closest Veterans Affairs medical center. But now, thanks to a first-of-its-kind telemedicine service, veterans throughout Vermont and New Hampshire can talk with a VA psychiatrist from a local doctor's office.

Rural: "This is something I've been trying to do for a decade," says Dr. Andrew Pomerantz, a psychiatrist at the VA in White River Junction, Vt., and the leader of the project. "Year after year I would put in proposals to build VA mental-health care into existing community care—non-VA care—and the answer was always 'no.' " Finally, in 2009, his proposal was funded with an $842,000 grant from the VA Office of Rural Health, thanks in part to support from Senator Bernie Sanders.

"If you live in a rural area, it is often extremely difficult to access the kind of quality psychiatric or psychological services that we want vets to have," Sanders told the Associated Press in January.

But lately, says Pomerantz, "there's more willingness on the part of the VA, nationally, to partner with community agencies." VA services are typically not integrated into private primary-care practices, where a lot of veterans get their care. The main reasons are security and cost. Setting up the initial seven practices required installing a T1 fiber-optic line to each location, so data can be transmitted securely, as well as purchasing a web camera and monitor for each office. As the first VA to try such a project, "we're having to solve all of the problems of contracting, privacy, security . . . all that," says Pomerantz.

About 20% of vets seek mentalhealth care, says Pomerantz.

So far, only a handful of veterans have made use of the service, but Pomerantz says that is because it's so new and hasn't been widely marketed yet. Thousands of veterans could potentially use it. About 20% of vets seek mental-health care, says Pomerantz. In Richford, Vt., for example, the first site to open, 300 to 400 veterans a year will likely use the service.

Drive: Once all seven locations are up and running, any veteran in Vermont or New Hampshire should be within "a reasonable drive" of VA mental-health care, says Pomerantz.


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