[AVAPL Members] Re: FW: Clinical Practice Recommendations for Dissemination to the Field & PCS

  • From: "Will-Wallace, Louise A." <Louise.Will-Wallace@xxxxxx>
  • To: <members1@xxxxxxxxx>, "VHA National Psychology Chiefs" <VHANationalPsychologyChiefs@xxxxxxxxxx>
  • Date: Wed, 18 Aug 2010 14:29:01 -0400

I am working with our Acting Director of Mental Health to look at our
organization of psychology and I would welcome the input of all of you
who have so much more history and experience than I.  I have been at
this VA for 19 years, but I have no other VA experience.  I am the
senior and lead psychologist with the same grade as all the others in
our service and a bargaining unit employee.  We have never had a service
line and until recently we only had 3-4 psychologists.

 

The issue is that currently we all answer to MDs (with one exception,
the second SPC position who answers to the initial SPC who answers to a
psychiatrist).

 

We now are approaching 20 and 4 are located outside MH services and 1 is
in a CBOC.  The 4 outside MH answer to MDs that are not psychiatrists.
We have had a variety of issues in the past such as getting testing
supplies, being used inappropriately to do tasks that could have been
done by clerks.  A psychologist has not routinely been involved in the
hiring of new psychologists especially those hired outside MH.  We
currently have 3 unlicensed psychologists (1 outside MH) and at one time
we had 5 which were almost half of our total number so hiring decisions
have been an issue.  I provide clinical supervision but not
administrative supervision to our unlicensed staff and their performance
appraisals are done by MDs.  We are repeatedly asked to do appropriate
things such as psychological assessments for our discipline but are not
organized in a manner to be efficient at delivering what we should be
delivering.   

 

At one time we were a Product Line and all staff answered to the Chief
of MH.   The nurses, social workers and even the clerks have gone back
to a service line that is by discipline and they are no longer directed
by the Chief of Mental Health who by history has always been a
psychiatrist.  Thus only psychologists directly answer to psychiatrists
so they can direct us to do anything, but cannot really direct others
and it has created difficulties in organizing the services we deliver.  

 

There were some very good reasons that all the other services pulled out
of MH similar to the ones we are experiencing.  Those groups are larger
and there was an equal or greater sized group to join with in the
Medical Center at large so there was more leadership and support for the
process of returning to a discipline specific organization.  Our current
acting director of MH is not a psychiatrist and is the first non
psychiatrist to lead our MH Service Line.  She is supportive, but the
psychiatrists have been very adamant that the Chief hired be a
psychiatrist and there is resistance to us having a separate service or
section.  Our current acting has asked me to get some input she can use
to help us determine a new organizational structure either within MH or
outside of mental health, but where most psychologists answer to a
psychologist (again referencing the 4 outside the MH service line).  I
do know of course that the Uniform Benefits Package outlines we should
answer to someone in our discipline, so far that has not been sufficient
to move our leadership and we are not much of a priority.   

 

I would greatly appreciate any assistance and of course you can respond
directly to me to not clog up everyone's mailbox or not if there is need
for discussion.  

 

Thanks in advance for your guidance,   Louise

 

 

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