VA- Primary Care Mental Health Integration (Meharry)

Supervisor(s):  Rhonda Venable, Ph.D.

Location: VA community based clinic at Meharry 1818 Albion Avenue, Nashville, TN

Clinical or Research Rotation: Clinical

Number of Positions Available:  1 (maybe 2)

Anticipated Number of Face-to-Face Clinical Hours per Week: 4-6 hours


Description: Primary Care-Mental Health Integration (PC-MHI) is the term VA uses to describe a set of mental and behavioral health care services that are provided to Veterans in collaboration with primary care providers.  Just as you might go to see your personal physician for a physical or a sore throat, you are working in an office where Veterans come to get their physical health needs met. The difference is that there are additional mental health services offered in the same location.  Interns will work with patients across the life span, from early 20s to early 90s. These services are fully integrated into the primary care setting (PACT), and support PACT-based treatment of both mental health conditions and behavioral aspects of chronic medical conditions. PC-MHI programs seamlessly combine evidence-based care management and co-located collaborative care services.

Interns may see a patient that you scheduled into your clinic for short term treatment. Conversely you may see a patient as a “warm handoff” from a nurse or physician who is concerned about the emotional health of the Veteran.   It is an opportunity to learn the complexities of a large multifaceted medical system. Part of your role in pcmhi is evaluating the services the Veteran may find beneficial and determining what referrals throughout the system may best meet those needs.

The integrated mental health services that PC-MHI programs provide address specific Veteran, provider, and health system needs and have a number of unique characteristics that differentiate them from traditional specialty mental health services.  It serves as the “first stop” for Veterans who may need mental health care.  Often these patients may not ever have sought out care if the provider was not co-located with their physical health care provider.  As an intern you have an opportunity to assist them in defining their experience of mental health treatment.

Competency Goals: At the end of your training experience the intern will have competence in the following objectives:

  1. To provide immediate access to clinical assessment and appropriate collaborative care and treatment for those experiencing mental health symptoms (either ad hoc or in response to screening).
  2. To practice collaborative, stepped and measurement-based care, including appropriate longitudinal follow-up, to address common mental health conditions for the primary care population.
  3. To enable optimal functioning of PACT teams(treatment teams in primary care) through collaborative decision support and interdisciplinary consultation with co-located mental health providers.
  4. To prevent the development of more severe symptoms through early recognition and intervention.
  5. As a member of PCMHI the intern will also provide neuropsychological screenings for cognitive impairment prior to referral to specialty care neuropsychological assessment.
  6. You will have the opportunity to learn the EBTs, CBT-Insomnia and Problem solving Therapy(PST).
  7. Have the ability to identify  appropriate treatment recommendations for patients who are not able to be treated in the short term mental health model.

Prerequisites: Psychology in primary care requires a person who is flexible and prepared for the unexpected. You will work closely with your supervisor on your cases (perhaps initially even hour to hour).   You will have a minimum of  an  hour  of supervision a week.  It is an exciting venue to train in and you will learn a lot. A desire to work closely across several professions is essential (nursing, primary care physicians, pharmacy, and social work). Often your work will be in exam rooms with patients and their families. The maximum number of sessions per patient is 6 sessions across a 6 month period.  Previous work in a health care setting is helpful but not essential.

Contact Information:  If you have any questions or are interested in this rotation, please contact Dr. Rhonda Venable at 615-873-6700 or 615-873-6503 or send me an email at