dr. cutler, what do you think? >> well i'm really glad you asked that question. >> let's not -- >> the bottom line -- >> let's not run the clock here. >> whether it's pain or depression, it takes an integrated approach. different patients need to start in different places. there are patients who will say i can't or won't talk about this and the medication will make it possible in a depression case. in a pain case there are people who absolutely need not to go where they mean to go into opiates or come opof them. they believe is this is what will work with me. we need to start where the veteran is. with my patients i have said i have a lot of different therapies, talk therapies and medication. these are the good and bad, what makes sense to you. by the way we can do both. and in most cases we end up doing both, but onften in a stepped way. >> in an ig report from 2013 it was recommended that va insure that facilities take action to improve post discharge follow up for mental health patients, particularly those who a

dr. cutler? >> i am glad you asked that question. the bottom line is pain or depression it takes the integrated approach. different patients need to star in different patients -- places some will say i will not talk about this and medication takes me -- makes that possible but with pain people need not to go where they need to go to opiates are to come off of them but they think it will work so start where the veteran is i have always said i have a lot of different tools with medication and therapy. what makes sense to you? we can't do both. in most cases we do. >> in the report from 2013 that facilities take action with the post discharge follow-up and in particular those two are identified high risk for suicide. what is being done to make sure the process is followed >> a few years ago we put out as the performance measure that veterans must be seen in person where at least by phone with in the first seven days after leaving a psychiatric hospital based on statistics it is the most vulnerable time faugh for a suicide attempt especi

dr. cutler, what you think? >> i'm glad you asked that question. the bottom line is this, whether it is pain or depression, it takes an integrated approach. different patients need to start in different places. there are patients who say they will not talk about this. a medication would make this possible. in a pain case there are people who need to not go where they mean to go into opioids, but believe this is all that will work. we need to start where the patient is. with my patient by voice said, i have a lot of different tools talk therapy and medication good and bad in each, one makes sense to you, we can devote area -- we can do both. >> in a report from 2013 it was recommended that ba facilities take action to improve post discharge follow-up. particularly those identified as high risk of suicide. what is being done to ensure that process -- this process is being followed. >> a few years ago, da put out as a performance measure that veterans us be seen in person or at least by phone in the first seven days after leaving a psychiatric hospita

dr. cutler you said you're doing oversight. and mr. williamson the g.o. says you're not. so what exactly is going on? >> the difference is the two years that have passed since this report was written. not questioning the report at all. in fact, i find the report helpful as a real spur to do more. but at this point we are making a difference in this and we've developed -- >> will you show me the results of the oversight you've done in the last two years? can you get that to me, you know within a reasonable period of time? like a month? >> that's not quite the way it is i think. i think there's still -- to respond to our recommendations on oversight i don't think v.a. has completed those yet. it's not the two or three-year lag at all. i think what we're talking about -- there have been some changes made. they're now a box checked on the behavioral autopsy report that indicates that oversight has been done. >> that's all you're saying that box, right? >> well, that's one of the things. they are revising guidelines. so they are making progress. but it's not been completed to