History of Northwest Mental Illness Research, Education and Clinical Center - MIRECC / CoE
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History of Northwest Mental Illness Research, Education and Clinical Center

History of the Northwest Mental Illness Research, Education and Clinical Center

The Northwest Mental Illness Research, Education and Clinical Center began with the many Veterans and Servicemembers who served their country and then found their lives unsettled by flashbacks, nightmares, thinking difficulties, and other mental health concerns. It begins with VISN 20 clinicians and researchers working late into a cool March night, drafting the NW MIRECC charter and dreaming of a collaborative approach to research, education, and clinical care that might better serve these Veterans. And it begins with a nationwide response by VA leaders and Congress, who funded leaders from the Puget Sound VA Health Care System and the Portland VA Health Care System in the fall of 1997 to establish one of the first three Mental Illness Research, Education, and Clinical Centers (MIRECCs) in the United States.

During its first years, the Northwest Mental Illness Research, Education and Clinical Center focused on posttraumatic stress disorder (PTSD), schizophrenia, and Alzheimer’s disease. That emphasis led to genetic discoveries in schizophrenia and to the identification of cerebrospinal fluid biomarkers for disruptive agitation in Alzheimer's disease. These findings were then passed on to clinicians and other VA personnel via MIRECC Presents, an interactive teleconference series that continues to this day but with enhanced web-related features for experiential learning.

However, since that time, the Northwest Mental Illness Research, Education and Clinical Center has adapted its mission to more readily address the most critical needs of Veterans in this region: PTSD and its associated conditions; traumatic brain injury (mTBI), substance use disorders, chronic pain, and dementia. The following three  factors compelled us to make this shift:

1. The return home of Veterans from Operations Enduring Freedom (OEF), Iraqi Freedom (OIF), and Operation New Dawn (OND) has substantially increased the already large number of Veterans who struggle with the distress and functional impairments of PTSD and its associated conditions.

2. The close geographic proximity (40 miles) of Department of Defense (DoD) Joint Base Lewis-McChord/Madigan Army Medical Center to VA Puget Sound has provided an exciting opportunity to develop innovative and productive research, education, and clinical care collaborations with DoD personnel that address military PTSD and its associated conditions in their early stages in active-duty Servicemembers.

3. It has become clear to NW MIRECC clinicians that posttraumatic stress disorder (PTSD) is usually complicated by at least one--and often multiple--associated conditions. The typical Operations Enduring Freedom (OEF), Iraqi Freedom (OIF), and Operation New Dawn (OND) combat Veteran with posttraumatic stress disorder (PTSD) -- as well as Veterans from the Vietnam War and other conflicts--also experiences persistent postconcussive symptoms (such as chronic headache) from one or multiple mTBIs; struggles with chronic musculoskeletal pain; is excessively using alcohol to relieve symptoms; and is increasingly concerned that his or her subjective cognitive symptoms will develop into dementia. These other conditions associated with PTSD demand the concentrated focus of multidisciplinary centers like the NW MIRECC.

One example of this renewed emphasis on posttraumatic stress disorder (PTSD) and its associated conditions has been our work with the blood pressure medication prazosin. Staff at the NW MIRECC pioneered the use of this medication to treat trauma-related nightmares, one of the most common symptoms of military PTSD. Due in part to our web-based and face-to-face educational outreach efforts, prazosin is now prescribed to over 100,000 Veterans and active-duty Servicemembers, and we continue to investigate its usefulness for other Veteran-related illnessess, including, for example, the postconcussive headaches that Veterans report as one of the most disabling symptoms of mild Traumatic Brain Injury (mTBI).