Feature

On Aug. 1, Antonette Zeiss, PhD, made history at the Department of Veterans Affairs (VA): She became the first psychologist, the first woman and the first nonphysician to head the department's mental health policy office.

Zeiss, whose official title is Chief Consultant for Mental Health for VA nationally, is based at the Central Office of the Department of Veterans Affairs in Washington, DC Her appointment has been greeted by warm messages of support and good will from psychologists and other mental health professionals throughout the system, underscoring the VA's commitment to support leadership in providing the best possible mental health care to veterans across the country.

Though her appointment is a milestone, it shouldn't be surprising. It fits perfectly with the VA's philosophy of interdisciplinary care and its emphasis on bringing all the mental health professions — psychiatry, psychology, social work, mental health nursing and counseling — to the table, says Zeiss.

"Hiring me is a statement about VA's commitment to mental health as an interdisciplinary component of health care," says Zeiss, who has spent much of the last 30 years both at the Palo Alto, Calif., VA and the VA Central Office helping create a culture of interdisciplinary care.

In addition to Zeiss's appointment, women psychologists hold two other positions of major leadership in VA Central Office: Lisa Thomas, PhD, who accepted the post of Veterans Health Administration Chief of Staff in July, and Mary Schohn, PhD, Acting Director of the Office of Mental Health Operations. They are among more than 3,700 psychologists working for the VA as clinicians, researchers and administrators.

And while Zeiss did compete against several psychiatrists for her job, guild issues did not factor into the choice. She was simply the perfect fit, says Madhulika Agarwal, MD, the VA's Deputy Under Secretary for Health for Policy and Services, who sat on the committee that hired Zeiss. "She is one of the most qualified professionals in her area of mental health," says Agarwal. "More importantly, she's an amazing communicator with a deep understanding of the mental health needs of the population we serve."

APA is thrilled by Zeiss's appointment as well as the placement of other psychologists in leadership roles at the VA, says Randy Phelps, PhD, APA's Deputy Executive Director for Professional Practice. "APA has been a longtime advocate of psychologists for top VA leadership roles," he says.

In fact, APA successfully advocated for a 1998 VA directive that removed professional discipline as a qualification for leadership positions, and for 2003 legislation that classified psychologists in a VA pay system similar to that of physicians. APA also annually co-sponsors the VA Psychology Leadership Conference, now in its 15th year, which encourages psychologists to move into key leadership positions in the VA health system.

"That Dr. Zeiss has become the head of the VA's mental health system, with an annual budget of $6 billion and 20,000 professional staff, is a tremendous personal accomplishment for her and a huge stride forward for our field," says Phelps.

Growing up in Santa Cruz, Calif., in the 1950s, Zeiss saw limited career choices for women. But she decided she'd major in psychology at Stanford University, and one of her first classes was an introductory psychology course taught by eminent psychologist Eleanor Maccoby, PhD. "I saw this amazing psychologist elegantly balancing work and family, and I knew I'd found a new and exciting home in which to build a career," says Zeiss.

At Stanford, she worked in the lab of personality psychologist Walter Mischel, PhD, and met the man who would become her husband, psychologist Robert Zeiss, PhD. Once married, they both headed to the University of Oregon for graduate school. She then worked as an assistant professor, doing clinical research, first at Arizona State University, then back at Stanford University as a visiting assistant professor, collaborating again with Mischel. But Stanford had closed its clinical program years earlier and Zeiss felt her work was too removed from patients so, after a year, she applied for a job as a clinical researcher at VA Palo Alto where her husband worked. She started out in the Center for Study of Psychotherapy and Aging. After a few months, she took a position as leader at VA Palo Alto for a national VA resource program, Interdisciplinary Team Training in Geriatrics — one of 12 such programs in the VA system. She stayed in this position for 11 years, as it developed and supported interdisciplinary team training and service delivery throughout the system, not just in geriatric settings.

"I loved what the VA was doing," says Zeiss, who worked to develop interdisciplinary teams to serve veterans of all ages and service eras. "The program was really innovative, thinking about how to create an effective team that includes psychology, pharmacology, nursing, social work, medicine and often many other disciplines as well."

In 1996, she became clinical director of psychology and training director for psychology interns and postdocs at VA Palo Alto. And later when then-President George H.W. Bush released the "President's New Freedom Commission on Mental Health Report," calling for a transformation of the mental health care system and a new emphasis on recovery, Zeiss was asked by leadership at VA Central Office to be part of the team implementing the report's recommendations at the VA.

In 2004, as she worked on the VA's strategic plan for expanding and transforming mental health services, she heard about an opening at the central office for a Deputy Chief Consultant in the Office of Mental Health Services. She held that positon beginning in 2005. That office develops policies and programs to serve veterans' mental health needs. Now, as head of that department, Zeiss works hand-in-hand with Schohn, whose office works directly with clinicians in the field to apply the policies that Zeiss's office develops.

"They need to work closely together to make sure the policies are implemented and executed," says Agarwal.

Together they are a formidable team, she adds. One priority the two are working on is tracking how well the nation's VA treatment centers are executing the VA's Uniform Mental Health Services Handbook, which defines the "essential components" of a comprehensive mental health program. These include holistic coordinated care, around-the-clock service, and care that is sensitive to gender and culture. "It's a revolutionary document that ensures that sites can't do really well in some things and neglect others completely," Zeiss explains.

She will also focus on implementing delivery of psychotherapy, with particular emphasis on evidence-based therapies. "Our emphasis is on psychotherapies that have the strongest evidence for effectiveness for post-traumatic stress disorder, depression, schizophrenia," she says. "We want to ensure that our staff is fully utilizing these therapies and that the people delivering them have sufficient training to use them with fidelity."


Beth Azar is a writer in Portland, Ore.