Enhanced VA Implementation Strategy - The enhanced implementation strategy will add external facilitation to the standard VA implementation strategies. External facilitation will begin with an assessment of the current workflow at the VHA Medical Center and the affiliated CBOCs using System Redesign methods. A member of the external facilitation team will conduct site visits at each VAMC and conduct telephone interviews with CBOC staff. The member of the external facilitation team will also collaborate with the local System Redesign staff member. To assess clinical workflow, the investigators will examine the administrative structure of the clinical units, staffing patterns, scopes of practice, service mix, standard operating procedures (e.g., patient check-in, screening, referrals, coding), job descriptions and annual evaluation criteria, and use of technology including telehealth, eHealth, mHealth, and the electronic health record. For the TOP intervention, key clinical workflow elements include: 1) how patients are referred to the care managers, 2) whether care managers are located at the VISN, VAMC or CBOC and in what administrative unit they are housed, 3) what type of psychotherapy is provided at the CBOC (e.g., anger management, PTSD groups, etc.), 4) formulary restrictions and prescribing patterns, 5) how psychiatric consultations are arranged, 6) how frequently patients are seen in mental health and primary care, caseloads, and wait times, 7) appointment scheduling procedures for mental health and primary care, 8) no show rates, 9) care manager software availability, 10) use of interactive video, clinical video telehealth to home, SmartPhone apps, 10) use of psychiatric rating scales, and 11) how workload credit is distributed. The external facilitation team will then generate a clinical workflow chart that describes the current process of care. With advice from the external facilitation team, the local champion will then incorporate the clinical process of the TOP intervention (including use of technology) into the current clinical workflow chart, making changes to the TOP intervention and/or current clinical workflow as needed. The local champion will also meet monthly with external facilitators to troubleshoot and make refinements.