About Northwest Mental Illness Research, Education, and Clinical Center (NW MIRECC)

About NW MIRECC

VA Puget Sound Health Care System (VAPSHCS) and VA Portland Health Care System (VAPORHCS) were commissioned by Congress and the VA as one of the first three MIRECCs in the United States. That center, the NW MIRECC, now provides protected research time, developmental study support, and new resources to a diverse, multidisciplinary cadre of biostatisticians, endocrinologists, geneticists, molecular biologists, neurologists, neuropsychologists, psychiatrists, radiologists, educators, clinicians, young investigators, and support staff, all of whom work together to deliver world-class, cutting-edge science, education, and clinical care to Veterans and health professionals at medical centers and community-based outpatient clinics throughout Veterans Integrated Service Networks (VISN) 20.

In the Pacific Northwest, VISN 20 serves Veterans in Alaska, Oregon, Washington, most of Idaho, and one county each in Montana and California. This important work spans three time zones and is only possible through productive collaborations with local and national academic, government, industry, military, and community partners. Currently, 18 VISNs function as regional care systems to better address local health care needs and enhance access to treatment. Encompassing 23% of the US's land area, VISN 20 is the largest geographic region of VA. As of the end of FY2024, 39% of VISN 20 enrollees resided in rural or highly rural areas.

The mission of VISN 20 MIRECC is to improve the health and well-being of Veterans by developing, evaluating, and disseminating novel effective treatments for military posttraumatic stress disorder (PTSD) and its complex comorbidities. The most prominent of these comorbidities is repetitive blast mild traumatic brain injury (mTBI); others are alcohol use disorder (AUD), chronic pain (in particular, post-concussive headaches), cognitive impairment, and increased risk for neurodegenerative disorders (chronic traumatic encephalopathy [CTE] and Alzheimer's disease [AD]). NW MIRECC applies modern genetic, neurologic, and clinical trial methodology to the discovery and development of new and more effective treatments for major and often treatment resistant mental disorders afflicting Veterans and the active duty combat personnel who will become Veterans.

VA MIRECC's provide for the improvement of the provision of health-care services and related counseling services to eligible veterans suffering from mental illness (especially mental illness related to service-related conditions) through—

• the conduct of research (including research on improving mental health service facilities of the Department and on improving the delivery of mental health services by the Department);
• the education and training of health care personnel of the Department; and
• the development of improved models and systems for the furnishing of mental health services by the Department.

NW MIRECC disseminates mission-relevant knowledge through publications and continuing health care education programs across VISN 20 and nationally. 

Research

VA ranks as one of the nation's leaders in health research. NW MIRECC research studies significantly contribute to advancements in our understanding of medical problems that lead to health improvements for Veterans and civilians alike. The knowledge produced by NW MIRECC research efforts is disseminated through web-based and face-to-face educational offerings nationwide and directly implemented in our specialty clinics throughout the Northwest. This collaborative approach to mental health has had a profound impact on the lives of Veterans. Most notably, staff at the NW MIRECC pioneered the use of the blood pressure medication prazosin to treat trauma-related nightmares, one of the most common symptoms of military PTSD. Due in part to our educational outreach efforts, this medication is now prescribed to over 100,000 Veterans and active-duty Servicemembers, and we continue to investigate its usefulness for other psychiatric conditions that are common in Veterans. NW MIRECC studies are conducted through clinical research and through translational research wherein teams of clinicians and scientists work side-by-side to characterize and model key features of clinical problems and then translate the findings from scientific theory or animal models into practical applications for Veterans. Research studies at NW MIRECC are currently enrolling Military Veterans, First Responders, Health Care workers, and Civilians in Seattle, Washington.

Education

NW MIRECC collaborates and consults with other MIRECCs and Centers of Excellence, as well as with other VA, Department of Defense (DoD), Federal, State departments of Veterans Affairs, community agencies, and experts. NW MIRECC seeks to improve the mental health and well-being of Veterans through research and dissemination of information to providers both within the VA and the general public. The collaborative approach to mental health research, education and treatment has had a profound impact on the lives of Veterans.

Enhance your skills and understanding of mental health issues affecting Veterans by attending MIRECC Presents. MIRECC Presents is a Continuing Education series on mental health topics provided by the VISN 20 NW MIRECC. MIRECC Presents is a major provider of continuing education accreditation for multidisciplinary VA providers, accomplished through a productive on-going collaboration with VA's Institute for Learning, Education and Development (ILEAD). This is a webinar series held on the first and third Wednesday of each month from October to June, between Noon and 1:00pm (PT).

➤ Disseminates best practice treatments, current research findings and the latest pertinent knowledge related to posttraumatic stress disorder (PTSD), mild traumatic brain injury, and their complex comorbidities through both web-based and face-to-face educational offerings.
➤ Collects and implements feedback from participant evaluations to ensure quality programing.
➤ Serves as a national resource for expertise in mental health education.

VA Advanced Fellowship Program in Mental Illness Research and Treatment (MIRT)

The MIRT Fellowship at VAPORHCS, is a 2-year research intensive training program. Fellows are trained in translational, clinical, and health systems research, advanced clinical care service delivery, and program administration in an interdisciplinary setting.

Snapshot

• 2 years
• 75% research/25% clinical
• Receive mentored training
• Develop and implement research projects
• Publish and present findings
• Train in and submit grants

Research Training

The primary goal of the NW MIRECC fellowship is to equip healthcare professionals with the knowledge and expertise to lead clinical research efforts that make a lasting impact on Veterans.

Advanced Fellows in the VAPORHCS program will join a rich research environment, ranked in the top 10 in VA research funding, with over 169 Principal Investigators, and over 585 active projects. In collaboration with their mentors, fellows will create a training plan tailored to their unique needs and career goals. Current opportunities exist to collaborate on a variety of clinical and health services research projects related to PTSD, traumatic brain injury, suicide prevention, treatment for chronic pain, sleep medicine, and more. Research methods used in current studies are diverse and include prospective research, randomized clinical trials, evidence synthesis, and qualitative research. VAPORHCS researchers have a wide range of statistical expertise and additional training and consulting opportunities may be available related to data management and statistical analysis. Over the course of the 2-year training program, fellows will design and implement projects, publish and present findings, and prepare grants for major federal funding mechanisms. The fellowship is designed with flexibility in mind and fellows are encouraged to curate a training experience that supports their individual goals.

Training Experiences

There are a variety of clinical training opportunities at VAPORHCS, and we support fellows in identifying opportunities that match their career goals. Fellows spend 25% of their time in clinical training to include direct patient care, preparation and notes, clinical supervision, and team meetings. There are often opportunities to gain tiered supervision experience. Psychology fellows can gain experience in a variety of mental health settings and interventions. This may include individual and group psychotherapy, assessment, and consultation. Medical Fellows will maintain clinical expertise in their respective fields with flexible, customized options spanning outpatient to inpatient care depending on their preferences. The MIRECC fellowship will work to align the clinical training opportunities to match the needs and goals for the fellow. 

Potential areas of focus include:

• Posttraumatic Stress Disorder
• Substance Use Treatment
• General Outpatient Psychology (BHIP)
• Traumatic Brain Injury
• Health Psychology
• Sleep Medicine
• Chronic Pain
• Neurodegenerative diseases (Alzheimer’s, Parkinson’s)

Clinical

MIRECC clinical programs stress a "precision medicine" approach to treating combat Veterans suffering from PTSD, mTBI, and their common comorbidities. NW MIRECC clinicians are essential for the diagnosis and management of mental health conditions. NW MIRECC clinicians serve in mental health clinics as well as specialty clinics that provide a key space for the development and evaluation of new treatments for PTSD, mild traumatic brain injury (mTBI), substance use disorders, chronic musculoskeletal pain, post-concussive headaches, and dementia. NW MIRECC specialty clinics also offer clinicians in-depth training in the diagnosis and management of mental health conditions. They have particular expertise in the off-label use of the blood-pressure medication prazosin for PTSD. Occasionally Veterans face challenges that perplex their mental health providers at the VA.

To assist providers with these more difficult cases, experts at the NW MIRECC developed the Mental Illness Consultation Program (MICON). In this program, VA clinicians may contact the NW MIRECC consultants with academic questions concerning a mental health topic or with clinical questions concerning unusual, complex, or difficult patient issues. A NW MIRECC investigator will return the provider's call or email within 48 hours and provide a free one-on-one consultation. MICON specializes in non-urgent psychiatric case consultation in PTSD, mTBI, SUD, dementia, and other areas in mental health.

VISN 20 MIRECC Partnerships

Today’s VHA has roots spanning over 150 years and continues to meet Veterans’ changing medical, surgical, and quality of life needs. The services provided to Veterans affected American society and culture as much as the service rendered by Veterans. VA's mission is to serve America’s Veterans and their families with dignity and compassion and be their principal advocate in ensuring that they receive medical care, benefits, social support, and lasting memorials. NW MIRECC substantially enhances the capacity and potential of VISN 20 to generate and disseminate new knowledge about mental illness, unseen wounds of war, and treatments. VA is committed to ensuring that Native American Veterans and their families are able to utilize all benefits and services they are entitled to receive. VISN 20 is home to 273 federally recognized American Indian and Alaskan Native tribes. According to DoD, American Indians and Alaska Natives have one of the highest representations in the United States Armed Forces. VA consults with American Indian and Alaska Native tribal governments to develop partnerships that enhance access to services and benefits by Veterans and their families.

The geographic proximity of DoD Joint Base Lewis-McChord (JBLM) Madigan Army Medical Center to the Seattle Washington VAPSHCS campus has provided an exciting opportunity to develop innovative and productive research, education, and clinical care collaborations with DoD personnel that address PTSD and its associated conditions in their early stages in active-duty Servicemembers. The 62nd Medical Squadron (MDS) - Joint Base Lewis-McChord currently delivers Integrated Disability Evaluation System (IDES) services at levels which significantly beat DoD standard. IDES is a joint DoD and VA disability evaluation process. Under IDES, VA helps DoD determine if wounded, ill, or injured Service members are fit for continued Military service and provide disability benefits to Service members and Veterans, if appropriate. VA Veteran Readiness and Employment (VR&E) program offers 5 support-and-services tracks to help Veterans get education or training, find and keep a job, and live as independently as possible. 

1. Reemployment track
2. Rapid Access to Employment track
3. Self-Employment track
4. Employment Through Long-Term Services track
5. Independent Living track

Disabled American Veterans (DAV) employment program connects transitioning Active-Duty, Guard and Reserve members, Veterans and their spouses with employers. RecruitMilitary and DAV have held 16 events in Joint Base Lewis McChord, drawing over 3,500 attendees and 819 exhibitors. There have been 31 events held in Seattle, drawing 8,441 attendees and 1,150 exhibitors. Career fairs are also held at U.S. Naval bases throughout the Pacific Northwest. Regional and National Virtual Career Fairs for Veterans are held online at https://my.recruitmilitary.com/.

NW MIRECC disseminates mission-relevant knowledge through publications and continuing health care education programs across VISN 20 and nationally. Sign up for email updates or access your subscriber preferences: https://public.govdelivery.com/accounts/USVHAVISN20/subscriber/new.

Use of these Materials and Finding VA Health Care

Please note that the health care information provided in these materials is for educational purposes only. It does not replace the role of a medical practitioner for advice on care and treatment. If you are looking for professional medical care, find your local VA healthcare center by using the VA Facilities Locator & Directory. This page may contain links that will take you outside of the Department of Veterans Affairs website. VA does not endorse and is not responsible for the content of the linked websites.

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VA Regional Offices

The Veterans Benefits Administration (VBA) helps service members transition out of military service, and assists with Veterans with education, home loans, life insurance and much more. Service members, Veterans, their families, and Survivors are invited to request information on VA Benefits including disability compensation, pension, fiduciary, education, Veteran Readiness and Employment (VR&E), Home Loans, and Insurance. In addition to information on VA Benefits Veterans may initiate an intent to file and request assistance with filing compensation and pension claims. Visit regional office websites to learn about the services the regional office provides, directions to the facility, hours of operation, and the leadership team that serves the regional office.

Find out if you can get VA health care as a Veteran

The following four categories of Veterans are not required to enroll but are urged to do so to permit better planning of health resources:

1. Veterans with a service-connected (SC) disability rated at 50% or more.
2. Veterans seeking care for a disability the military determined was incurred or aggravated in the line of duty, but which VA has not yet rated, within 12 months of discharge.
3. Veterans seeking care for a SC disability only or under a special treatment authority.
4. Veterans seeking health registry examinations. VA’s health registry evaluation is a free, voluntary medical assessment for Veterans who may have been exposed to certain environmental hazards during military service. The evaluations alert Veterans to possible long-term health problems that may be related to exposure to specific environmental hazards during their military service. VA has established several health registries to track and monitor the health of specific groups of Veterans. You may be eligible to participate in one or more of these health registries: Agent Orange Registry, Airborne Hazards and Open Burn Pit Registry, Gulf War Registry (includes Operations Iraqi Freedom and New Dawn), Ionizing Radiation Registry, Depleted Uranium Follow-Up Program, and Toxic Embedded Fragment Surveillance Center. Use the chart below to help determine your eligibility.

Find out how to apply for VA health care benefits as a Veteran or service member. For other mental health services, contact a VA medical center for information on eligibility and treatment options.

Community Care (Mission Act)

The MISSION Act became law in 2018, bringing the VA’s previous Veterans Choice Program to an end and establishing the Community Care Program. VA provides health care for Veterans from providers in your local community outside of VA. Veterans may be eligible to receive care from a community provider when VA cannot provide the care needed. This care is provided on behalf of and paid for by VA. Community care is also available to Veterans based on certain conditions and eligibility requirements, and in consideration of a Veteran’s specific needs and circumstances. VA offers urgent care services to eligible Veterans at in-network urgent care clinics to treat minor injuries and illnesses that are not life-threatening, such as colds, strep throat, sprained muscles, and skin and ear infections. Community care must be first authorized by VA before a Veteran can receive care from a community provider.

Vet Centers in VISN 20

Vet Centers in VISN 20 are community-based counseling centers that provide a wide range of social and psychological services, including professional readjustment counseling to eligible Veterans, active-duty Army, Navy, Marine Corp, Air Force, Space Force, and Coast Guard service members, including National Guard and Reserve components, and their families. 1-877-927-8387 is an around the clock confidential call center where combat Veterans and their families can call to talk about their military experience or any other issue they are facing in their readjustment to civilian life. The staff is comprised of combat Veterans from several eras as well as families members of combat Veterans. This benefit is prepaid through the Veteran’s military service.

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Washington

Plan your trip to VA

In 1946, Veterans Canteen Service (VCS) was established by law to provide comfort and well-being to America’s Veterans. With our many retail stores, cafés and coffee shops across the country, we serve those who have served our country. VCS is proud to offer Veterans enrolled in VA healthcare, their families and VA employees exclusive shopping benefits online through Patriot Store Direct. Product categories range from Military Caps and apparel, Outdoors, Electronics, Automotive tires (Goodyear, Bridgestone, Firestone, and Fuzion), Tickets and Travel, Vision (Glasses and Contact Lenses), Home and Kitchen, Floral, Toys, Gifts, Watches, and more. We are honored to give back to the VA community through many programs established for the health and well-being of our nation’s heroes. Revenues generated from VCS are used to support a variety of programs, such as VA’s Rehabilitation Games, Fisher Houses, Poly-Trauma Centers for OEF/OIF/OND Veterans, disaster relief efforts, Substance Abuse Cessation, VA’s Homelessness initiatives, Women Veterans, Veteran Suicide Prevention and other activities.

Hospital Service Directory

To find out whether there is a van near you, use the Disabled American Veterans (DAV) Hospital Service Coordinator Directory to contact your nearest HSC. The vans are driven by volunteers, and the rides coordinated by more than 133 Hospital Service Coordinators around the country. Our nation’s heroes travel around the globe to protect our freedoms—it’s only right that we return their dedication. Volunteering to drive a Vet ensures that even those living remotely from VA hospitals can make their appointments and never go without the treatment they need. Please remember that the DAV Transportation Network is staffed by volunteers; therefore, it is unable to cover every community. Learn more about the DAV transportation network through the VISN 20 NewsFlash Resources section.

Today's VHA - the largest of the three administrations that comprise the VA - continues to meet Veterans' changing medical, surgical, and quality-of-life needs. There are 18 Veterans Integrated Service Networks (VISNs) in VHA operating as regional systems of care to better meet local health care needs and provides greater access to care. In the Pacific Northwest, VISN 20 serves Veterans in Alaska, Oregon, Washington, most of Idaho, and one county each in California and Montana. Spanning 23% of the US land mass, VISN 20 is the largest geographic region of VA. Operating across three time zones over 817,417 square miles, VISN 20 is home to 273 federally recognized American Indian and Alaskan Native tribes. According to DoD, American Indians and Alaska Natives have one of the highest representations in the United States Armed Forces. VA consults with American Indian and Alaska Native tribal governments to develop partnerships that enhance access to services and benefits by Veterans and their families. VA is committed to ensuring that Native American Veterans and their families are able to utilize all benefits and services they are entitled to receive. As of the end of FY2024, 39% of VISN 20 enrollees resided in rural or highly rural areas.

• VISN 1: VA New England Healthcare System
• VISN 2: New York/New Jersey VA Health Care Network
• VISN 4: VA Healthcare - VISN 4
• VISN 5: VA Capitol Health Care Network
• VISN 6: VA Mid-Atlantic Health Care Network
• VISN 7: VA Southeast Network
• VISN 8: VA Sunshine Healthcare Network
• VISN 9: VA MidSouth Healthcare Network
• VISN 10: VA Healthcare System
• VISN 12: VA Great Lakes Health Care System
• VISN 15: VA Heartland Network
• VISN 16: South Central VA Health Care Network
• VISN 17: VA Heart of Texas Health Care Network
• VISN 19: Rocky Mountain Network
• VISN 20: Northwest Network
• VISN 21: Sierra Pacific Network
• VISN 22: Desert Pacific Healthcare Network
• VISN 23: VA Midwest Health Care Network