Psychologist assumes top mental health position at the VA
September 30, 2011—On August 1, 2011, APA member Antonette M. Zeiss, PhD, made history: She became the first psychologist – and first woman – to serve as chief consultant for the Office of Mental Health Services at the Department of Veterans Affairs (VA) Central Office.
The move has great symbolic importance, says Zeiss. “It signals that the VA is committed to the leadership directive that the field is expected to follow, which says that any mental health leadership position should be open to any of the four core mental health professions: psychiatry, psychology, social work and nursing,” she says. “It indicates that we take that seriously and that mental health is not under the direction of any single profession, but is inherently interdisciplinary and collaborative.”
“Previously, the top mental health position in VA has always been a psychiatrist. It has been APA’s advocacy goal and my personal dream for 15 years that a psychologist head the system, so we are thrilled by Dr. Zeiss’s well-deserved achievement,” says Randy Phelps, PhD, deputy executive director for professional practice at APA’s Practice Directorate. He and other leaders with the Association of VA Psychologist Leaders (AVAPL) and APA Division 18 (Psychologists in Public Service) have long advocated for psychologists to achieve top VA leadership roles.
As chief consultant, Zeiss will recommend mental health policy to the VA’s leadership and work to ensure that the VA has the resources it needs to provide mental health care to veterans. She oversees a staff of 20,271 mental health professionals and a fiscal year 2012 budget of $6.153 billion.
Zeiss joined the Palo Alto VA as a staff psychologist in 1982. She soon became director of a training program designed to teach VA staff how to work as effective interdisciplinary teams. From 1996 to 2005, Zeiss served as assistant chief and director of training, psychology service, at the Palo Alto VA.
Zeiss was invited to help craft the VA’s comprehensive mental health strategic plan, an invitation that came as a result of her role as chair of APA’s Committee on Aging. In 2005, Zeiss came to the Central Office to help put the plan into action and became deputy chief consultant.
Since then, the number of mental health professionals within the VA has soared – the result of funding increases targeting “mental health enhancement.” The number of psychologists jumped from 1,685 in 2005 to 3,709 today, for example, making the VA the nation’s largest employer of psychologists.
That growth spells opportunities for psychologists not just as clinicians but in leadership roles. Leadership positions in programs staffed by more than one discipline are open to all mental health disciplines, Zeiss points out. “We encourage and mentor psychologists to be effective applicants,” she says.
Zeiss credits her own leadership development with step-by-step increases in responsibility. Even in her pre-VA days as an academic at Arizona State University, her leadership skills were evident in her transformation of the psychology clinic used to train graduate students. “I took that clinic from a place that was very tiny and not financially well-founded to a place that was going strong and supporting several grad students,” she remembers.
Now Zeiss spends her days preparing for congressional briefings and hearings, meeting with veterans’ service groups and other stakeholders, writing and scouring the research for information that could be used to inform the VA’s mental health policy. “Meetings take up a huge amount of time,” she laughs.
As she settles into her new role, Zeiss has three main goals:
Redefining health care. The VA is trying to shift from a problem-focused, symptom-oriented, medical model of health care to a veteran-centered model, says Zeiss. Such a system, she explains, will emphasize patients’ strengths and their collaboration with health care providers rather than their problems. “We want mental health to be a leader for the VA in helping to make that transition for all of health care,” she says.
An crucial part of this transformation is the integration of mental health into primary care. The VA uses a model of co-located, collaborative care, with psychologists and other mental health professionals embedded in primary care clinics to tackle both mental health problems plus obesity, pain, insomnia and other conditions with a behavioral health component. Psychologists can also help interdisciplinary teams function effectively, says Zeiss. “You can’t just throw a group of people together and tell them they’re a team,” she says. “Psychologists have a real understanding of group dynamics.”
Implementing the Uniform Mental Health Services Handbook. This document defines the VA’s mental health policies and outlines what mental health care should be delivered throughout the system. “We’ve made great strides in full implementation, but we’ve still got a ways to go in terms of ensuring that all medical facilities and our associated community-based outpatient clinics are delivering all the care that’s captured in the handbook,” says Zeiss.
Ensuring funding. “We face an uncertain economic climate and uncertain budgeting for the VA in the future,” says Zeiss. “There needs to be leadership to sustain resources for the VA generally and for mental health.”
Ask Zeiss if she misses working directly with patients, and the answer is yes. “I really loved working with vets,” she says. “They’re wonderful people.”
APA is very proud of Dr. Zeiss for achieving the top mental health leadership post at VA, says Phelps. “How many psychologists do you know who oversee more than 20,000 mental health professionals and an annual budget that exceeds $6 billion? Dr. Zeiss’s accomplishment is a huge stride forward for our field.”