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Methods Initially, Re-Engage was implemented at 158 VA facilities by mental health providers who received the standard REP strategy to support uptake (implementation manual, training, and technical assistance). Re-Engage involved giving providers a list of patients with serious mental illness who had not been seen at their facility for at least a year, requesting that providers contact these patients, assess their clinical status, and where appropriate, expedite VA healthcare appointments. At month 6, facilities considered non-responsive(N = 88, total of 3,200 patients), defined as <80% of patients on providers’ lists with updated assessment of clinical status, were randomized to receive either Enhanced REP (REP+Facilitation; N = 39 practices) for 6 months followed by standard REP for 6 months; or continued standard REP (N = 49 practices) for 6 months followed by 6 months of Enhanced REP for facilities still not responding. Enhanced REP consisted of monthly phonebased coaching by national experts in Re-Engage on overcoming adoption barriers. Quantitative outcomes included attempted contacts and subsequent receipt of outpatient care.

Cluster randomized trial comparing standard versus enhanced implementation strategies for improving outreach to persons with SMI: 12-month results