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VISN 4 MIRECC Newsflash

Spring 2021

MESSAGE FROM THE DIRECTOR

Recently I’ve been reflecting on how honored I am to work with such a resourceful and proactive team throughout the pandemic. In spite of the challenges of this past year, our MIRECC found inventive ways to move research forward while keeping Veterans and staff safe. Meanwhile, our Center has stepped up to support clinical behavioral health initiatives at our sites as well. I believe these experiences will only strengthen our Center’s ability to reach more Veterans in the future.

Even as we embark on this return to more “normal” times, the pandemic will leave its footprint. In the coming months and years, we will learn much more about the mental health effects of COVID-19, including the social and economic tolls that have come with the virus. We will also continue to learn more about the systemic disparities, further highlighted by this current health crisis, that contribute to health outcomes. All of these lessons will be critical to understanding how we can continue to improve mental health care for Veterans through our research, education, and clinical missions. Our work is never finished, but I’m eager to see where we go next.

David Oslin, M.D.

Director, VISN 4 MIRECC

VACCINATING VETERANS WITH MENTAL HEALTH NEEDS

In an effort to ensure that Veterans with mental health needs are vaccinated against COVID-19, VISN 4 MIRECC staff in both the Cpl. Michael J. Crescenz VA Medical Center (CMCVAMC) and the VA Pittsburgh Healthcare System (VAPHS) have been partnering with their respective clinical behavioral health teams to reach these at-risk Veterans.

Recently published research indicates the critical, life-saving importance of COVID-19 vaccine access for patients with mental illness. Not only are these patients more likely to be infected, but a study published in January 2021 in JAMA concluded that those with severe mental illness were significantly more likely to die from the virus. Poorer general health, barriers to care, as well as environmental and lifestyle factors all contribute to these outcomes.

"Getting Veterans vaccinated against the COVID-19 virus is one of the most important health care activities in front of us. As many of the Veterans we serve suffer from mental illnesses, it is critical that we plan outreach activities and specific events for these patients."

–DAVID OSLIN, M.D.
Director, VISN 4 MIRECC
Associate Chief of Staff for Behavioral Health, CMCVAMC


Recently published research indicates the critical, life-saving importance of COVID-19 vaccine access for patients with mental illness. Not only are these patients more likely to be infected, but a study published in January 2021 in JAMA concluded that those with severe mental illness were significantly more likely to die from the virus. Poorer general health, barriers to care, as well as environmental and lifestyle factors all contribute to these outcomes.

With these factors in mind, at Philadelphia’s CMCVAMC, Behavioral Health and MIRECC staff pitched in to make personal phone calls to thousands of Veterans of all ages to sign them up for vaccination appointments at a specialized clinic. Among the advantages of this clinic are that Veterans are able to receive their vaccine in a familiar setting, and that for patients who haven’t been in care for an extended period, the event is an opportunity to reconnect.

“It was wonderful to talk to all the patients in line—to hear their stories and thoughts about the vaccine as well as about other things on their minds,” said Julie Low, M.D., CMCVAMC psychiatrist and division director for Behavioral Health outpatient services. “And that we were able to reach such a vulnerable population who usually are left out of all of the gifts of health care and society—well, that was huge, too.”

At Pittsburgh’s VAPHS, our MIRECC, including Marci Gaither, Ph.D. and Sarah Forster, Ph.D., also teamed up with Behavioral Health and Public Affairs to promote vaccination by developing a three-piece enhanced mailing with educational materials for Veterans with mental health needs.

“MIRECC was instrumental in helping us identify the patients we really wanted to support the outreach to,” said VAPHS psychologist Marci Gaither, Ph.D.

Dr. Gaither explained that the messaging introduced the concept of the virus risk and highlighted Veterans’ resiliency. Since many patients with psychosis often lack connection to Primary Care, the mailings included information about how to get scheduled with VA Primary Care. They also advised Veterans about how to get connected to Behavioral Health, Homelessness clinical resources, Pharmacy, and the Veterans Crisis Line (1-800-273-8255 – Veterans Press 1). The documents also encouraged the effectiveness of vaccines and even featured a vaccinated Veteran engaged in VA care who touted the vaccine as safe and effective.

HONORS & ACHIEVEMENTS

Matthew Chinman, Ph.D. received the 2020 Daniel Deykin Award for Outstanding Mentor from VA HSR&D. This award honors dedication and skill in mentoring the next generation of health services researchers. Dr. Chinman, who has served as a mentor to 41 mentees over his career to date, has focused his research on Peer Specialists and Implementation Science, working to improve mental health services for those with serious mental illnesses (SMI) through the use of Peer Specialists. As one of Dr. Chinman’s mentees commented, “Beyond the traditional career counseling and education that characterizes most mentors, Matt mentors by example. His passion, professionalism, and respect for all persons is truly inspiring.” Read the full story here.

Emily Hartwell, Ph.D. received the 2021 Margaret ‘Emily’ Gere Book Award (Research Award for a Third-Year Fellow) from the VA Office of Academic Affiliations Advanced Fellowship Program in Mental Illness Research & Treatment (MIRT). Dr. Hartwell, whose research has focused on pharmacogenetics and precision medicine approaches for the treatment of substance use disorders, was selected based on her academic accomplishments and for doing work highly relevant to Veterans’ mental health.

David Oslin, M.D. was presented with the 2020 John B. Barnwell Award as part of VA’s 2021 National Research Week celebrations (May 17-21). Dr. Oslin’s research focuses on two main areas: the development and implementation of measurement-based care practices, and genetic research to bring precision mental health care to Veterans and others. As CMCVAMC Chief of Staff John Kelly, M.D., commented, Dr. Oslin “is a true triple threat as a clinician, an educator, and a researcher. The Barnwell Award recognizes his past and continuing contributions to the discipline of behavioral health for our nation’s Veterans and by spread of innovation to the rest of the country.” Read the full story here.

RESEARCH SPOTLIGHT

At our Pittsburgh site, Million Veteran Program (MVP) team members (Beatrice Chakraborty, Psy.D., Cathy Boarts, Patrick Strollo, M.D., FACP, FCCP, FAASM, and Gretchen Haas, Ph.D.) hit an exciting and remarkable benchmark: the study enrolled its 15,000th participant, a 96-year-old woman who is a WWII Veteran.

The VA Pittsburgh Healthcare System has been the top enrollment site for MVP in the entire VA since reopening enrollment in February 2021!

Learn more about MVP here.

PUBLISHING HIGHLIGHTS

Ramsey CM, Lynch KG, Thase ME, Gelernter J, Kranzler HR, Pyne JM, Shih MC, Stone A, PRIME Care Executive Committee, Oslin DW. Prevalence of Predicted Gene-Drug Interactions for Antidepressants in the Treatment of Major Depressive Disorder in the Precision Medicine in Mental Health Care Study. Journal of Affective Disorders. January 2021. [link]

Kranzler HR, Morris PE, Pond T, Crist RC, Kampman KM, Hartwell EE, Lynch KG. Prospective Randomized Pharmacogenetic Study of Topiramate for Treating Alcohol Use Disorder. Neuropsychopharmacology. February 2021. [link]

Longenecker JM, Bagby RM, McKenzie K, Pollock BG, George TP, Voore P, Quilty LC. Cross-Cutting Symptom Domains Predict Functioning in Psychotic Disorders. Journal of Clinical Psychiatry. February 2021. [link]

Rosen AC, Bhat JV, Cardenas VA, Ehrlich TJ, Horwege AM, Mathalon DH, Roach BJ, Glover GH, Badran BW, Forman SD, George MS, Thase ME, Yurgelun-Todd D, Sughrue ME, Doyen SP, Nicholas PJ, Scott JC, Tian L, Yesavage JA. Targeting Location Relates to Treatment Response in Active But Not Sham rTMS Stimulation. Brain Stimulation. April 2021. [link]

Schutt RK, Schultz M, Mitchell-Miland C, McCarthy S, Chinman M, Ellison M. Explaining Service Use and Residential Stability in Supported Housing: Problems, Preferences, Peers. Medical Care. April 2021. [link]

Bentzley BS, Han SS, Neuner S, Humphreys K, Kampman KM, Halpern. Comparison of Treatments for Cocaine Use Disorder Among Adults: A Systematic Review and Meta-analysis. JAMA Network Open. May 2021. [link]

EXPERTS IN THE NEWS

Adam Bramoweth, Ph.D. was featured on the bilingual educational website, duermebien/sleepwell, which posts video interviews with experts in sleep medicine. Dr. Bramoweth discusses insomnia and cognitive behavioral therapy for insomnia (CBT-I) here. (March)

Dominick DePhilippis, Ph.D. of the Philadelphia Center of Excellence for Substance Addiction Treatment and Education (CESATE) was interviewed on Boston’s NPR station WBUR about contingency management (CM) for stimulant addiction treatment. (April)

Michael Thase, M.D. spoke briefly to KMVT in Twin Falls, Idaho, highlighting May as National Mental Health Care Month. (May)

David Oslin, M.D. and Kyle Kampman, M.D. were included in Philadelphia Magazine’s 2021 “Top Doctors” list. (May)

VA and Military Medicine Outlook published two articles about the work of Dr. Oslin. One discusses Primary Care Mental Health Integration (PCMHI); the other describes his Precision Medicine in Mental Health (PRIME) Care study (see p. 46 at this link). (May)

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Contact

David W. Oslin, M.D.
Director, VISN 4 MIRECC
Cpl. Michael J. Crescenz VA Medical Center
215-823-5894
dave.oslin@va.gov