The VA Office of Inspector General (OIG) conducted a national review to evaluate the governance structure and responsibilities related to the Veterans Integrated Service Network (VISN) Chief Mental Health Officer (CMHO) role.
The OIG found that VHA communicated inconsistent mandatory and discretionary VISN staffing requirements. Failure to provide consistent staffing requirements likely contributes to VISN leaders’ inadequate understanding of priority positions and lack of standardization.
VISN leaders did not consistently utilize the standardized organizational chart and used a variety of titles to represent the CMHO role; the OIG identified inaccuracies within VISN-provided organizational charts. The absence of consistent information regarding organizational governance structure and staffing may result in inequities in resources and oversight of VISN and facility mental health staff and services.
The OIG determined that Office of Mental Health leaders established multiple avenues to facilitate communication with CMHOs.
The OIG found that CMHO functional statements varied in format and content and did not consistently align with performance plan elements. While flexibility based on unique VISN needs is important, the OIG would expect the inclusion of critical responsibilities to be identified consistently in both CMHO functional statements and performance plans.
All CMHOs reported providing oversight of specific mental health programs and services; however, half of the CMHOs described lack of authority as a major barrier to effectively overseeing and implementing actions for facility-level mental health services. Office of Mental Health and Office of Suicide Prevention leaders suggested that standardization of the CMHO position description would be helpful in increasing the effectiveness of the role.
The OIG made five recommendations to the Under Secretary for Health related to VISN staffing requirements, the use of the VISN organizational chart, alignment of CMHO functional statements and performance plans, and CMHO role authority.
