Responding to the PTSD Responding to the PTSD Crisis Among Returning Crisis Among Returning VetsVetsSession 5065.0Session 5065.0

Ron Manderscheid, PhDRon Manderscheid, PhDConstella Group, LLCConstella Group, LLC&&Johns Hopkins UniversityJohns Hopkins University

Short HistoryShort History

Spring 2006 – Initial White Spring 2006 – Initial White Paper, Paper, Helping Veterans Helping Veterans Return.Return.

White Paper published in White Paper published in Archives of Psychiatric Archives of Psychiatric NursingNursing and and Behavioral Behavioral Healthcare.Healthcare.

Nature of the ProblemNature of the Problem

Problem is significant (35-40%), Problem is significant (35-40%), with expected large numbers 450-with expected large numbers 450-500 thousand.500 thousand.

Most will suffer from PTSD, Most will suffer from PTSD, Depression, Anxiety, and Depression, Anxiety, and Substance Use Disorders.Substance Use Disorders.

Epidemiology confirmed by the Epidemiology confirmed by the DoD DoD Mental Health ReportMental Health Report, issued , issued in June 2007.in June 2007.

Key Elements of the Key Elements of the White PaperWhite Paper Recommended Approach:Recommended Approach:

– GIS and mapping.GIS and mapping.– Outreach to public and not-for-profit Outreach to public and not-for-profit mental and substance use services (new mental and substance use services (new partnerships). partnerships).

– Availability of a call center for Availability of a call center for anonymous care.anonymous care.

– Creation of a virtual support group, Creation of a virtual support group, with care elements.with care elements.

– Testing in key sites, with appropriate Testing in key sites, with appropriate evaluation.evaluation.

Key Service Issues in Key Service Issues in Project AreaProject Area DoD vs. VA vs. National DoD vs. VA vs. National GuardGuard

Units vs. VAMCs vs. StatesUnits vs. VAMCs vs. States Need for a Fusion CenterNeed for a Fusion Center

Potential Future Potential Future ResearchResearch

Epidemiology and Surveillance:Epidemiology and Surveillance: How many vets have problems, how How many vets have problems, how severe are the problems, and how severe are the problems, and how are these vets distributed?are these vets distributed?

Volunteers vs. Draftees: Volunteers vs. Draftees: Volunteer army personnel come Volunteer army personnel come predominantly from poverty areas predominantly from poverty areas and poor families.and poor families.

Potential Future Potential Future ResearchResearch

Large Scale Analytical Large Scale Analytical StudiesStudies: Who is using what : Who is using what services with what effects?services with what effects?

DoD and VA VistA Electronic DoD and VA VistA Electronic Health RecordsHealth Records

State encounter records.State encounter records.

Potential Future Potential Future ResearchResearch

Evaluation StudiesEvaluation Studies: Are the : Are the clinical interventions clinical interventions working as planned? What working as planned? What needs to be improved?needs to be improved?

Field studies vs. controlled Field studies vs. controlled studies studies

Potential Future Potential Future ResearchResearch

Family Impact Studies: Family Impact Studies: What What impact does the ill vet have impact does the ill vet have on the family unit? On on the family unit? On spouse? On children?spouse? On children?

20 suicides of vets/day.20 suicides of vets/day.

Potential Future Potential Future ResearchResearch

Preventive Interventions within a Preventive Interventions within a Public Health FrameworkPublic Health Framework: How can : How can these problems be prevented these problems be prevented before they occur?before they occur?

Resiliency TheoryResiliency Theory Social Support TheorySocial Support Theory Analogues from other major stress Analogues from other major stress situations.situations.

Potential Funding Potential Funding SourcesSources DOD – CDMRP DOD – CDMRP VISN/VAMC—Services Research VISN/VAMC—Services Research FundsFunds

Targeted HHS ProjectsTargeted HHS Projects Projects Authorized by State Projects Authorized by State LegislaturesLegislatures

Contact InformationContact Information

Ron Manderscheid, Ph.D.Ron Manderscheid, Ph.D. Director, Mental Health and Substance Use Director, Mental Health and Substance Use

ProgramsPrograms Constella Group, LLCConstella Group, LLC 6003 Executive Boulevard, Room 4166003 Executive Boulevard, Room 416 Rockville, Maryland 20852Rockville, Maryland 20852 240-514-2607 (Voice)240-514-2607 (Voice) 301-787-1414 (Cell)301-787-1414 (Cell) 240-514-2601 (Fax)240-514-2601 (Fax) rmanderscheid@constellagroup.comrmanderscheid@constellagroup.com www.constellagroup.comwww.constellagroup.com Enhancing human health around the world, Enhancing human health around the world,

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