# Optimizing Psychiatrist Appointment Frequencies to Improve Mental Health Access

> **NIH VA I21** · VA BOSTON HEALTH CARE SYSTEM · 2020 · —

## Abstract

Background: Ensuring timely access to mental health services remains a major challenge for VA. In
particular, access to psychiatrists was identified as a critical bottleneck by the Office of Inspector General
(OIG)'s 2012 Review of Veterans' Access to Mental Health Care. The OIG's 2015 follow-up audit found that
many VA facilities do not have explicit psychiatrist staffing plans. It is therefore important for facilities to (i)
optimize the allocation of available outpatient psychiatrist appointment slots across Veterans such that those in
need of more intense care can be seen more often by their psychiatrists compared to others who are in less
need of active treatment or frequent monitoring, and (ii) accurately plan psychiatrist staffing levels to match the
optimal appointment frequency needs of the population of Veterans that they treat.
Significance/Impact: Frequency of mental health appointments is predefined for VA-endorsed evidence-
based psychotherapies (e.g., once-a-week for 12 weeks). However, optimal psychiatrist appointment
frequencies for Veterans who are not, or no longer, undergoing such structured therapies are not well
established. We recognize that the appropriate appointment frequency for a Veteran ought to be a case-by-
case clinical decision based primarily on the psychiatrist's expertise and the Veteran's preferences, supported
by best available evidence. However, there exists little evidence on which appointment frequencies can be
safely and appropriately considered for which Veterans. This pilot launches a program of research for
supporting optimal allocation of care resources, to effectively enhance access and improve outcomes. This
proposed pilot research thus (i) directly addresses VA's priorities of Improved Timeliness and Efficiency as
outlined in its Fiscal Year 2018-2019 Operational Plan, and also (ii) facilitates the use of VA data as a national
resource, which is currently set forth as one of VA Research's top priorities.
Innovation: Our work will specify mathematical optimization functions/parameters to construct computational
models that provide information to innovatively support mental health care planning. Based on findings from
this pilot, a subsequent IIR will develop, implement, and evaluate novel decision support tools.
Specific Aims: Aim 1: Systematically identify an expert panel-endorsed (i) definition of stable Veterans to
include in this investigation (e.g., treated in the general mental health clinic and psychiatrically stable with no
psychotropic medication changes over six months) and (ii) definition of Veteran-level mental health outcomes
(e.g., psychiatric emergency room visits / hospitalizations, major medication changes, medication adherence)
to utilize in Aim 2 for risk assessments based on CDW data. Aim 2: Computationally analyze optimal
psychiatrist appointment frequencies to develop a risk-stratified list of minimum psychiatrist appointment
frequencies that are unlikely to result in a negativ...

## Key facts

- **NIH application ID:** 9834427
- **Project number:** 1I21HX002812-01A1
- **Recipient organization:** VA BOSTON HEALTH CARE SYSTEM
- **Principal Investigator:** Bo Kim
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-02-01 → 2021-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9834427

## Citation

> US National Institutes of Health, RePORTER application 9834427, Optimizing Psychiatrist Appointment Frequencies to Improve Mental Health Access (1I21HX002812-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9834427. Licensed CC0.

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