Sec. 401. Analysis of feasibility and advisability of Department of Veterans Affairs providing evidence-based treatments for the diagnosis of treatment-resistant depression
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Congress makes the following findings: A systematic review in 2019 of the economics and quality of life relating to treatment-resistant depression summarized that major depressive disorder (in this subsection referred to as MDD ) is a global public health concern and that treatment-resistant depression in particular represents a key unmet need. The findings of that review highlighted the need for improved therapies for treatment-resistant depression to reduce disease burden, lower medical costs, and improve the quality of life of patients.
The Clinical Practice Guideline for the Management of MDD (in this subsection referred to as the CPG ) developed jointly by the Department of Veterans Affairs and the Department of Defense defines treatment-resistant depression as at least two adequate treatment trials and lack of full response to each. The CPG recommends electro-convulsive therapy (in this subsection referred to as ECT ) as a treatment strategy for patients who have failed multiple other treatment strategies.
The CPG recommends offering repetitive transcranial magnetic stimulation (in this subsection referred to as rTMS ), an intervention that is indicated by the Food and Drug Administration, for treatment during a major depressive episode in patients with treatment-resistant MDD. The final report of the Creating Options for Veterans’ Expedited Recovery Commission (commonly referred to as the COVER Commission ) established under section 931 of the Jason Simcakoski Memorial and Promise Act (title IX of Public Law 114–198 ; 38 U.S.C. 1701 note) found that treatment-resistant depression is a major issue throughout the mental health treatment system, and that an estimated 50 percent of depressed patients are inadequately treated by available interventions.
The COVER Commission also reported data collected from the Department of Veterans Affairs that found that only approximately 1,166 patients throughout the Department were referred for ECT in 2018 and only approximately 772 patients were referred for rTMS during that year. Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall complete an analysis of the feasibility and advisability of making repetitive transcranial magnetic stimulation available at all medical facilities of the Department of Veterans Affairs and electro-convulsive therapy available at one medical center located within each Veterans Integrated Service Network for the treatment of veterans who are enrolled in the patient enrollment system and have a diagnosis of treatment-resistant depression.
The analysis conducted under subsection
(b)shall include an assessment of the final report of the COVER Commission submitted under section 931(e)(2) of the Jason Simcakoski Memorial and Promise Act (title IX of Public Law 114–198 ; 38 U.S.C. 1701 note). Not later than 180 days after the conclusion of the analysis conducted under subsection (b), the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report that includes the following: The results of such analysis. An assessment of the number of veterans who are enrolled in the patient enrollment system and who have a diagnosis of treatment-resistant depression per Veterans Integrated Service Network during the two-year period preceding the date of the report. An assessment of the number of the veterans who are enrolled in the patient enrollment system who have a diagnosis of treatment-resistant depression and who have received or are currently receiving repetitive transcranial magnetic stimulation or electro-convulsive therapy as a treatment modality during the two-year period preceding the date of the report. An assessment of the number and locations of medical centers of the Department that currently provide repetitive transcranial magnetic stimulation to veterans who are enrolled in the patient enrollment system and who have a diagnosis of treatment-resistant depression. An assessment of the number and locations of medical centers of the Department that currently provide electro-convulsive therapy to veterans who are enrolled in the patient enrollment system and who have a diagnosis of treatment-resistant depression. In this section: The term patient enrollment system means the system of annual patient enrollment of the Department of Veterans Affairs established and operated under section 1705(a) of title 38, United States Code. The term veteran has the meaning given that term in section 101(2) of title 38, United States Code.
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Sec. 401
Analysis of feasibility and advisability of Department of Veterans Affairs providing evidence-based treatments for the diagnosis of treatment-resistant depression
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