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White River Junction VA Medical Center, Vermont

Mental Health Intensive Case Management (MHICM)

What is Mental Health Intensive Case Management (MHICM)?
Mental Health Intensive Case Management (MHICM) is a community based program for veterans with very disabling mental health problems who live within an hour's drive of the WRJ VAMC.  The program provides mental health services to eligible veterans in their homes and communities.  The goal of the MHICM program is to support veterans in their recovery goals and minimize demoralizing crises.   To do this, the MHICM team members provide:

  • Frequent home or community visits.
  • Instruction, education and counseling about severe psychiatric conditions.
  • Support around developing coping skills.
  • Assistance with addressing housing, income, vocational and/or family concerns.
  • Referral to community resources and services.
  • Care coordination of other VA services and community services according to veterans' needs.
  • Education and support to family and close friends.

Veterans are eligible for MHICM if they:

  • have a Severe and Persistent Mental Illness (e.g. Schizophrenia, Bipolar Disorder).
  • live within an hour's drive of the WRJ VAMC.
  • are able to function in the community (manage activities of daily living, manage own medication, etc.) (Do not need to be in a nursing home or group home.)
  • accept MHICM as their primary mental health care team.
  • have a home environment that is safe for the well-being of vet, vets caregiver(s), and the MHICM team members.
  • have a complex mental health condition that requires the skills of an interdisciplinary health care team.

Needs Assessment for MHICM: Once a veteran has been referred to the MHICM team, he or she is evaluated by a team member.  This assessment gathers information about mental health conditions, health, coping, resources and current needs.  The MHICM team will discuss this information and determine if MHICM would be the best option to address the referred veteran's needs.   

Acceptance and Ongoing Care: Once accepted into the program, the team asks veterans to complete an assessment of their symptoms and concerns. This assessment is repeated every six months. Team members meet with veterans enrolled in the MHICM program 1-3 times per week and veterans may call the team in between visits.  Family members or friends may be involved in the veteran's treatment, depending upon the desires of each veteran.

Visits by the MHICM team:  MHICM team members (nurse, social worker, psychiatrist, etc.) will visit as needed to help vets with treatment concerns.  Vets and the MHICM team will decide how often and when visits are made.  The visits are scheduled in advance and are based upon need. 

Treatment Process:  MHICM provides intensive support in face to face meetings and phone contact. We also offer assistance in providing information and recommend resources for veteran's family members and supporters. A treatment planning meeting with the entire team, is held initially, every six months, to clarify goals.  In this meeting we will discuss goals, needs, resources and how the team can best help. 

MHICM at White River Junction, VT VA

There are 100 Urban MHICM programs throughout the VA system.  The MHICM program at VAMC White River Junction is a rural pilot program and consists of the following team members: 

  • Daniel G Guertin, LICSW - Coordinator / Social Worker 
  • Scott Rebhun, MD - Attending Psychiatrist             
  • Bob Landry, RN - Nurse
  • Michelle Greenwood, MA - Psychology Technician
  • Lauren Smith - Psychology Technician
  • Kathleen Turnbaugh - Psychology Technician

How to Access Services

To use these services, veterans should be referred by a current provider.  If veterans don’t have a provider, they should go to the PMHC, our walk-in clinic located in Primary Care.

Hours:  Monday-Friday 7:00AM-4:00PM,
 
The phone number for the PMHC is 1-802-295-9363 ext. 6132.