Chaplains play important roles in caring for Veterans and Service members with mental health problems. As part of the Department of Veterans Affairs (VA) and Department of Defense (DoD) Integrated Mental Health Strategy, we used a sequential approach to examining intersections between chaplaincy and mental health by gathering and building upon: (1) input from key subject matter experts; (2) quantitative data from the VA/DoD Chaplain Survey (N = 2,163; response rate of 75% in VA and 60% in DoD); and (3) qualitative data from site visits to 33 VA and DoD facilities. Findings indicate that chaplains are extensively involved in caring for individuals with mental health problems, yet integration between mental health and chaplaincy is frequently limited due to difficulties between the disciplines in establishing familiarity and trust. We present recommendations for improving integration of services, and we suggest key domains for future research.

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Leaders in health care chaplaincy and practice guidelines, such as the Association of Professional Chaplains' Standards of Practice, call for chaplains to develop an evidence-based approach to their work. The extent to which practicing chaplains accept this new paradigm is unclear. The aim of this study was to gather information regarding chaplains' attitudes and practices with respect to evidence-based chaplaincy care. Data for the study came from surveys of healthcare chaplains working in the Department of Veterans Affairs (VA, n = 440), the Department of Defense (DoD, n = 164), and civilian settings (n = 169). Chaplains from all three contexts strongly endorsed an evidence-based approach to chaplaincy. Approximately three-fourths of the healthcare chaplains from VA and DoD and 42% of those from civilian settings considered their current chaplaincy practices to be evidenced based, with over half in VA and DoD samples and 94% in the civilian sample indicating that they would like their chaplaincy care to be more evidence-based. Approximately half of the VA and DoD chaplains and 35% of the civilian chaplains reported currently using measurement tools in their chaplaincy care. These results suggest that there is generally strong support among practicing chaplains for an evidence-based approach to chaplaincy care.

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This paper describes the development, implementation, and outcomes of a quality improvement learning collaborative that aimed to better integrate chaplaincy with mental health care services at 14 participating healthcare facilities evenly distributed across the Department of Veterans Affairs (VA) and Department of Defense (DoD). Teams of healthcare chaplains and mental health professionals from participating sites sought to improve cross-disciplinary service integration in six key domains: screening; referrals; assessment; communication and documentation; cross-disciplinary training; and role clarification. Both chaplains and mental health providers across the entire facilities at participating sites were significantly more likely post collaborative to report having a clear understanding of how to collaborate and to report using a routine process for screening patients who could benefit from seeing the other discipline. Foundational efforts to enhance cross-disciplinary awareness and screening practices between chaplains and mental health professionals appearing particularly promising.