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MIRECC/CoE Mental Health Innovations Newsletter - May 2014

Research topic on PTSD and Sleep Education topic on provider education Clinical topic on tele-health

Engaging Community Partners in the Support of Returning Veterans

Research

VA Researchers Train Community Mental Health Providers

VA developed the Community Provider Toolkit to provide information on VA services and resources, promote understanding of military culture and experience, and supply tools for working with a variety of mental health conditions. Dr. Carie Rodgers has taken that effort a step forward to pilot a training program for community providers based upon the model that has been highly successful within VA. Training initiatives within VA have resulted in greater numbers of mental health providers delivering evidence-based treatments for PTSD, including Cognitive Processing Therapy (CPT). We are very hopeful that this project will help expand access to evidence-based treatment for PTSD for Veterans and active military personnel who choose to receive care in the community.However, many Veterans receive care in community-based clinics and medical centers outside the VA system. Wherever they receive care, Veterans should have the option of benefiting from evidence-based treatments. Unfortunately, evidence-based treatments for PTSD are not widely available in the community. Intensive training, such as that provided within VA, may be difficult for community clinicians to access or to engage in because of time limitations.

Dr. Rodgers and her colleagues at the VISN 22 Center of Excellence for Stress and Mental Health (CESAMH) partnered with the Tug McGraw Foundation to address barriers to training community practitioners in CPT. Reaching out to national organizations and local agencies, the study offered community practitioners the opportunity to receive training in CPT. Fifty-five community practitioners engaged in an intensive training over two to three days. They were also offered weekly consultation for six months following the training, giving them the opportunity to learn from a treatment expert. Importantly, Dr. Rodgers added a Motivational Interviewing component to the training to identify and address specific barriers that clinicians might face in providing CPT in a community setting. The study, which is assessing clinicians’ use of and satisfaction with CPT, is in its final stages of data collection. The findings may provide insights into how best to collaborate with community clinicians in serving returning Veterans. Dr. Rodgers notes, “We are very hopeful that this project will help expand access to evidence-based treatment for PTSD for Veterans and active military personnel who choose to receive care in the community.”

Education

Veterans Tactical Response: Keeping Law Enforcement and Veterans Safe

VA develops training for law enforcement that addresses Veterans’ issues.

Law enforcement personnel frequently respond to crisis situations that involve mental health issues. The need for specialized training in this area has gained national attention. Although not unique to Veterans, combat Veterans can have elevated rates of mental health difficulties, such as posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). Whether responding to a routine traffic violation or more serious situations, law enforcement personnel can benefit from training to understand mental health conditions, such as PTSD and TBI, to help them manage these situations in a way that increases safety for all involved. Dr. Sandra Morissette and colleagues at the VISN 17 Center of Excellence for Research on Returning War Veterans partnered with local agencies in Texas, including the Austin Police Department, Office of Acquired Brain Injury, and Central Texas Health Care System, to find solutions. Together, they developed training for law enforcement personnel on military culture and Veteran mental health issues. This training has been provided seven times thus far to agencies including local law enforcement in Texas, the Federal Bureau of Investigation, and the Bureau of Alcohol, Tobacco, Firearms and Explosives. The training has been well received. Participants said that much of the information in the training was new to them and that they believed it would be very helpful when responding to calls. By educating the community to be sensitive to military culture, this program has also served to reduce stigma regarding Veteran mental health issues. A training manual and video-training package is being developed. Future plans include conducting research to examine the usefulness and effectiveness of the training program in everyday law enforcement practice.

Clinical

Connecting with Communities through Peer Support: North Carolina Vet-to-Vet

VA partners with North Carolina Division of Mental Health to create a communitybased Veteran peer initiative.

Dr. Harold Kudler and colleagues at the VISN 6 MIRECC have partnered with the North Carolina Division of Mental Health to create a community-based Veteran peer initiative entitled North Carolina Vet-To-Vet (NCV2V). North Carolina communities will support returning Veterans by offering certified peer support specialist services throughout the state. Peer support specialists are Veterans who have personal experience managing and recovering from mental illness and bring this unique expertise to their work. NCV2V will place peer specialists in each of North Carolina’s 100 counties where they will provide services to Veterans and their family members within those communities. In teams of two, peer specialists will meet with Veterans and their families to provide short-term, problem-solving support that address the stressors of transitioning from military to civilian life. Examples include assistance with relationships, crisis intervention, stress management, family tensions, parent-child communications, and family separations and reunions. The program will also connect Veterans and their families with other state and community transition support services as well as local family support systems. This program will provide valuable information about whether this model of service is well received by Veterans, if it is effective in easing transition challenges for returning Veterans, and whether it should be more broadly disseminated.

There are 15 VA specialized mental health centers of excellence which include 10 Mental Illness Research, Education and Clinical Centers (MIRECCs), 4 Mental Health Centers of Excellence, and the National Center for PTSD. The centers share a mission to improve the health and well being of Veterans through cutting-edge science, education, and clinical initiatives. Mental health problems are often multiple complex conditions. Each center addresses a particular mental health disorder, environmental situation or Veteran cohort. To learn more about these centers, go to www.mirecc.va.gov.

Noosha Niv, PhD (Editor), Shannon McCaslin, PhD and MIRECC Communications Workgroup (Contributors)