About the Authors

Madhulika Agarwal, MD, MPH serves as the Deputy Under Secretary for Health for Policy and Services for the Department of Veterans Affairs. Her organization’s vision is to lead policy and services development to ensure the best possible health care outcomes for our Nation’s Veterans.

Agarwal provides executive leadership and direction to many of VA’s Chief Officers and other senior executives, including the Office of Assistant Deputy Under Secretary for Policy and Planning and the new Office of the Assistant  Deputy Under Secretary for Health for Informatics and Analytics,  Office of Public Health; Office of Patient Care Services; Office of Ethics in Healthcare; Readjustment Counseling; Office of Health Information;  Office of Research and Development and Office of Interagency Health Affairs.

Prior to her 2011 appointment as Deputy Under Secretary for Health, Agarwal served as the Department’s Chief Officer for Patient Care Services.  In this position, she led system-wide initiatives to enhance key clinical services that focus on personalized, accessible, high quality healthcare delivery.  Some examples of initiatives undertaken while she was Chief Officer included the development of a Suicide Prevention Program to provide immediate assistance to veterans in mental distress; the MOVE program, which focuses on lifestyle changes and weight management through diet and exercise; the development of VA’s Polytrauma System of Care for seriously injured veterans; and the expansion of comprehensive Home and Community Based Care services including Home Based Primary Care and the Medical Foster Home program designed to enable veterans to remain in their homes and communities.

Before being appointed Chief Officer, Agarwal served as the Associate Chief of Staff for Ambulatory Care at the VA Medical Center, Washington, DC, where she was an Adjunct Assistant Professor of Medicine at Georgetown University and Howard University.

Agarwal received her medical degree from Rajasthan University in India. She completed her training in Internal Medicine at the Georgetown University Program in Washington, DC. She has completed her Masters in Public Health at George Washington University in Washington DC.  She is also a graduate of VA’s Executive Career Field Program and Executive Fellows Program.

Bradley Karlin is National Mental Health Director for Psychotherapy and Psychogeriatrics for the U.S. Department of Veterans Affairs (VA), in VA Central Office, Washington, DC.  He has national responsibility for developing, implementing, and evaluating mental health programs in evidence-based psychotherapy and psychogeriatrics in the VA healthcare system.  Dr. Karlin has helped developed and oversees national initiatives to disseminate and implement evidence-based psychotherapies for PTSD, depression, serious mental illness, substance use conditions, motivation, insomnia, and chronic pain, for which he received a Certificate of Commendation from the Secretary of the Department of Veterans Affairs.  As part of VA’s efforts to disseminate evidence-based psychotherapies, Karlin has overseen the development, implementation, and evaluation of national competency-based staff training programs in cognitive processing therapy and prolonged exposure therapy for PTSD; cognitive behavioral therapy, acceptance therapy, and interpersonal psychotherapy for depression; social skills training for serious mental illness; cognitive behavioral therapy for insomnia; cognitive behavioral therapy for chronic pain; motivational enhancement therapy and behavioral couples therapy for substance use conditions, and motivational interviewing for motivation and adherence.  National program evaluation data show that the training in and implementation of evidence-based psychotherapies in the VA healthcare system has led to significant positive training outcomes for therapists and significant improvements in patient outcomes (e.g., Karlin et al., 2012; Karlin, Trockel, et al., in press; Karlin, Walser, et al., in press).

Karlin has also helped expand geriatric mental health programs in the VA health care system, with a focus on new models of practice.  He has developed and implemented an initiative to place a full-time mental health provider on all 130+ VA Home-Based Primary Care teams, as well as a national initiative to integrate psychologists in VA nursing homes (now called “Community Living Centers”).  He has also led the development and implementation of STAR-VA – a multi-component, psychosocial intervention for managing challenging dementia-related behaviors, based on the STAR training program (Teri, Huda, Gibbons, Young, & van Leynseele, 2005) – in 17 Community Living Centers.  STAR-VA has been shown to result in clinically significant reductions in the frequency and severity of dementia-related behaviors, as well as in reductions in depression and anxiety (Karlin, Visnic, McGee, & Teri, in press).

Karlin received his B.A. in political science and sociology from the University of Michigan, graduating with highest distinction and Phi Beta Kappa.  He received his MS and PhD in clinical psychology from Texas A&M University, where he also completed proficiency in clinical geropsychology.  He completed a clinical internship and a postdoctoral fellowship in clinical geropsychology at the VA Palo Alto Health Care System.

Karlin is also Adjunct Associate Professor in the Department of Mental Health of the Bloomberg School of Public Health at Johns Hopkins University.  He is a Fellow of the American Psychological Association and a past-Secretary of the Society of Clinical Geropsychology of APA.  He is a licensed clinical psychologist and has special clinical interests in depression, grief and loss, and geropsychology.  He has numerous publications, presentations, and government briefings related to mental health care access, utilization, and policy, and is a co-author of several therapy manuals, including a comprehensive therapist manual for Cognitive Behavioral Therapy for Depression in Veterans and Military Servicemembers.  Karlin is an editorial board member or reviewer for several mental health and policy journals and serves as a member or chair of several national steering committees, advisory groups, and workgroups.  He also has a significant interest in public outreach, particularly on mental health issues related to underserved populations, and has been involved in numerous outreach efforts through national print and television media.  Karlin is a recipient of a number of national awards, including the Outstanding Administrator Award from the VA Section of APA and the Spotlight Award from the Division of Psychologists in Public Service of APA.