This work was supported by the VHA Health Services Research and Development Service (IIR 10-314) and the Center for Organization Learning and Management Research of the VA Boston Healthcare System. The authors thank the VHA National Center for Organization Development for managing and providing access to the VHA All Employee Survey data used in this study. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the VA or the U.S. government.
Dr. Penfold reports that he received financial support from Bristol-Myers Squibb for research regarding medication augmentation strategies for major depression. The other authors report no competing interests.