An Innovative Approach to Assessment of Serious Mental Illness: Combining Therapeutic Assessment and Assertive Community Treatment Models
Kelley McNary PsyD (1), Julia Merchant PsyD (1), Jalan Gatchell MA (1, 3), Andrew Peckham PhD (1, 2),
1: Department of Veteran Affairs Boston, MA 2: UMass Chan Medical School, Worcester, MA 3: William James College, Newton, MA
Background: A Serious Mental Illness (SMI) assessment clinic at a VA hospital identified that many veterans experienced limited diagnostic clarity and access to effective treatment, particularly for medication management. Traditional single session psychodiagnostic evaluations included longer sessions, making engagement difficult for this population and limiting behavioral observations and rapport building for assessors.
Methods: To address these challenges, the authors implemented a novel assessment approach for veterans with SMI, integrating elements of Therapeutic Assessment and Assertive Community Treatment (ACT). This model aimed to emphasize collaborative assessment, center the veteran in the diagnostic process, enhance diagnostic clarity, reduce stigma, and increase accessibility and practical relevance of treatment recommendations. The approach also redefined roles for assessors and treatment teams to better support veterans' needs.
Results: Clinic operations began in September 2025, with sixteen referrals and nine completed assessments; some veterans did not respond or deferred evaluation. Four psychology trainees participated in specialized training and supervision. In August 2026, the clinic was incorporated as an official rotation for doctoral interns. Seven veterans received either new or clarified diagnoses, leading to more tailored treatment plans. Despite these successes, challenges remained with interdisciplinary collaboration, veterans attending follow-up appointments, and psychosocial barriers impacting access to evaluation and care recommendations.
Conclusions: Preliminary results indicate this assessment model is feasible and valuable within the VA Healthcare System. Consistent referrals and meaningful assessment outcomes benefitted veterans and their treatment teams. The clinic also provided enhanced specialty assessment training opportunities for psychology trainees. Future directions include expanding training capacity, increasing the number of veterans served, and further developing the ACT components to strengthen community-based support.