Chats on Change: Home Base Program for Veterans With PTSD

Chats on Change: Home Base Program for Veterans With PTSD

Event Date: 
Tuesday, June 18, 2013

Thank you for participating in the Chat on Change held June 18, 2013. During the TweetChat, we were joined by Dr. Rebecca Weintraub Brendel from the Red Sox Foundation and Massachusetts General Hospital (MGH) Home Base Program, and Dr. Benjamin Miller from the University of Colorado Denver School of Medicine.

Participants

 

 

The Red Sox Foundation and Massachusetts General Hospital Home Base Program was created in 2009 to serve Iraq and Afghanistan veterans and families affected by combat or deployment-related stress and traumatic brain injury (TBI) – the “invisible wounds of war.” The Home Base Program provides clinical care and support services for service members, veterans, and their families throughout New England; offers community education about the “invisible wounds of war” and the challenges facing military families; and conducts research to improve understanding and treatment of posttraumatic stress disorder and TBI. It is estimated that as many as one in three Iraq and Afghanistan veterans experience the effects of one of these conditions.

 

 
 
 
Rebecca Weintraub Brendel, MD, JD Clinical Director, Veterans Program, Home Base Program

Dr. Rebecca Weintraub Brendel is Clinical Director of the Veterans Program at the Red Sox Foundation and Massachusetts General Hospital (MGH) Home Base Program. She has served as a psychiatrist at the Law & Psychiatry Service and the Consultation Psychiatry Service and as faculty of the Center for Law, Brain, and Behavior at MGH. She previously served as Associate Director of the Harvard Forensic Psychiatry Fellowship. Dr. Weintraub Brendel is an Assistant Professor of Psychiatry at Harvard Medical School.

Dr. Weintraub Brendel graduated from both University of Chicago Law School and Pritzker School of Medicine. She completed her psychiatry residency at MGH and McLean Hospital and a forensic psychiatry fellowship at MGH. From 2006 – 2007, Dr. Weintraub Brendel was the Edmond J. Safra Faculty Fellow in Ethics at Harvard University. A Massachusetts attorney, she is also a Fellow and Councilor of the Academy of Psychosomatic Medicine. She serves on the Ethics Committees of the Massachusetts Psychiatric Society and the American Academy of Psychiatry and the Law, and chairs the Standards and Ethics Subcommittee of the Academy of Psychosomatic Medicine.

Dr. Weintraub Brendel’s educational efforts and research interests are informed by her broad clinical practice and focus on issues at the interface of psychiatry, medicine, law, ethics, and human rights. For these efforts, she was awarded the 2008 Stoudemire Award from the Academy of Psychosomatic Medicine and the 2009 Isaac Ray Award from the Massachusetts Guardianship Association. She regularly teaches in both medical and legal continuing education programs.

 
 
Benjamin Miller, PsyD Director of the Office of Integrated Healthcare Research and Policy Department of Family Medicine University of Colorado Denver School of Medicine 

Dr. Miller is an Assistant Professor in the Department of Family Medicine at the University of Colorado Denver School of Medicine where he is responsible for integrating mental health across all three of the Department’s core mission areas: clinical, education, and research. He is currently the Director of the Office of Integrated Healthcare Research and Policy in the Department of Family Medicine.

Dr. Miller is the Director of Information and Policy - Collaborative Care Research Network. He has been the principal investigator on several federal grants examining mental health integration and primary care. He has written and published on enhancing the evidentiary support for collaborative care models, increasing the training and education of mental health providers in primary care and the need to address specific health care policy for integration. Dr. Miller often travels speaking on clinical, operational and financial components of integrating mental health and primary care as well as the policy implications for these strategies. He is the section editor for Health and Policy for Families, Systems and Health and the president of the Collaborative Family Healthcare Association.

 

Transcript

miller7: 30 minutes until #AHRQIX tweetchat on #veterans and #PTSD - follow along with #AHRQIX hashtag!
homebaseprogram: Prepping for 12p ET #tweetchat #pts #veterans with @AHRQIX @miller7 - hope you can join us in a few! #ahrqix
homebaseprogram: RT @miller7: 30 minutes until #AHRQIX tweetchat on #veterans and #PTSD - follow along with #AHRQIX hashtag!
AHRQIX: Our TweetChat on #veterans, #PTSD & mental health with @homebaseprogram & @miller7 starts in 15 minutes! Join us using #AHRQIX
TheChatDiary: Join: @AHRQIX is hosting a TweetChat on veterans & #PTSD at 12pm ET with @homebaseprogam & @miller7. Join in using #AHRQIX
miller7: What are your thoughts about #veterans and #mentalhealth? Come join the #AHRQIX starting now (well, in 4 minutes)! cc @DocForeman
AHRQIX: Our TweetChat on mental health & #veterans with #PTSD with Dr. Brendel of @homebaseprogram & @miller7 is about to begin! #AHRQIX
AHRQIX: We’re using #AHRQIX for the chat. Please include it in your tweets
AHRQIX: If you have a question and want to tweet during the chat, be sure your tweets are not protected. #AHRQIX
AHRQIX: We may collect, save, & post transcripts from our chats on our Web site. See our privacy policy at go.usa.gov/rvWJ #AHRQIX
AHRQIX: .@homebaseprogram & @miller7 will be tweeting along with us, so please follow the stream of tweets on Twitter by searching for #AHRQIX
AHRQIX: This chat will focus on veterans, PTSD, and mental health. Please be respectful of others during the chat. #AHRQIX
AHRQIX: Welcome to our TweetChat on mental health & veterans with #PTSD! I’m Nicole & I’ll be moderating the chat. #AHRQIX
AHRQIX: I’m pleased to be joined by Dr. Rebecca Brendel of @homebaseprogram & Dr. Ben Miller (@miller7). #AHRQIX
AHRQIX: Dr. Brendel is the Clinical Director of the Veterans Program at the @RedSox_Fund & @MassGeneral's @homebaseprogram #AHRQIX
AHRQIX: .@miller7 is an Assistant Professor in the Department of Family Medicine at the @CUDenver School of Medicine. #AHRQIX
AHRQIX: Please note the Innovations Exchange does not provide advice on health-related issues or experiences.#AHRQIX
AHRQIX: We’ll ask/answer Qs w/ @homebaseprogram, @miller7 & participants, as well as share resources on mental health, veterans & #PTSD #AHRQIX
miller7: Welcome everyone! #ahrqix
miller7: Dr. Brendel, tell us a little about the @homebaseprogram. What is it? When did the clinic first open its doors to vets? #AHRQIX
miller7: Some background on @homebaseprogram homebaseprogram.org/general-inform… #ahrqix
AHRQIX: We're talking about @RedSox_Fund & @MassGeneral's @homebaseprogram today. Here's their #innovation profile: go.usa.gov/bj7F #AHRQIX
homebaseprogram: Since 2009, Home Base @RedSox_Fund @MassGeneralNews provides clinical care, education, research #vets #families w/ #PTS #TBI #ahrqix
homebaseprogram: #combatstress, #PTS, #TBI are the signature wounds of the wars in Iraq and Afghanistan #ahrqix
miller7: MT @homebaseprogram: #combatstress, #PTS, #TBI are the signature wounds of the wars in Iraq and Afghanistan #ahrqix #mentalhealth
miller7: What makes the Home Base Program unique? @homebaseprogram #AHRQIX
homebaseprogram: We treat vets & families for comprehensive evaluation and care regardless of discharge status or ability to pay #ahrqix
miller7: Participants, what is your experience working with #veterans or military families in your medical practices? #AHRQIX
miller7: For those not familiar with the prevalence of #PTSD in our vets, check out the data ncbi.nlm.nih.gov/pmc/articles/P… #healthcare #AHRQIX
nickdawson: @tomcampbellric —> RT @miller7: Participants, what is your experience working with #veterans or military families? #AHRQIX
AHRQIX: Coordinating mental health & primary care improves engagement go.usa.gov/bjHV @Harvard @samhsagov @Penn @DeptVetAffairs #AHRQIX
miller7: In my world, we often work with #primarycare practices better detect #PTSD in vets and population writ large ncbi.nlm.nih.gov/books/NBK12669… #AHRQIX
miller7: @nickdawson @tomcampbellric Nick, wearing your administrators hat, how can we better take care of our vets? #AHRQIX
RachelHeafield: RT @AHRQIX: Coordinating mental health & primary care improves engagement go.usa.gov/bjHV @Harvard @samhsagov @Penn @DeptVetAffairs …
AHRQAcademy: June is #PTSD Awareness Month! Learn more about PTSD at ptsd.va.gov/index.asp & in the #AHRQIX Tweetchat with @miller7
nickdawson: Biggest opportunity I see, from admin perspective, is to consider med trained vets for caregiver jobs in health systems. #AHRQIX
homebaseprogram: 1 in 3 veterans returns w/ #PTS or #TBI and “for every warrior there are 10 worriers” back home. - we treat both vet and family #ahrqix
AHRQIX: RT @AHRQAcademy: June is #PTSD Awareness Month! Learn more about PTSD at ptsd.va.gov/index.asp & in the #AHRQIX Tweetchat with @miller7
AHRQIX: RT @homebaseprogram: 1 in 3 veterans returns w/ #PTS or #TBI and “for every warrior there are 10 worriers” back home. - we treat both vet …
miller7: @nickdawson Kind of like a train the trainer or a peer training program? #AHRQIX
nickdawson: @miller7 job angle is slightly different from direct care, but I imagine it’s a win/win for both health systems and vets #AHRQIX
homebaseprogram: At Home Base Base, vets are key part of our treatment team - the first person a vet meets is another combat vet @nickdawson #ahrqix
miller7: Dr. Brendel, can you describe the Home Base treatment model? @homebaseprogram #AHRQIX
miller7: @homebaseprogram @nickdawson Wow, that is impressive. When you recruit vets to participate, how do they usually respond? #ahrqix
nickdawson: @miller7 I’m not educated enough to know best approach. But a combat medic has applicable skills as a nursing asst, ER tech, etc #AHRQIX
homebaseprogram: We use a comprehensive team-based approach for #PTS #TBI and other co-morbidities #ahrqix
nickdawson: @homebaseprogram I’d think vets must function a lot like #ePatients in healthcare. They are expert navigators and supporters #AHRQIX
mlottmanier: @nickdawson @miller7 Peer service (vets helping vets) programs are indispensable, but funding them, at least in CO, isn't easy #AHRQIX
homebaseprogram: #vets and #families receive pyscho-social support as well as clinical treatment #ahrqix
miller7: @mlottmanier @nickdawson I would bet that most peer programs have a hard time with sustainability - requires a different model? #ahrqix
AHRQIX: Here are clinical practice guidelines for managing #PTSD via @DeptofDefense @DeptVetAffairs @VeteransHealth go.usa.gov/bjtH #AHRQIX
MakeItVisible: RT @AHRQIX: TweetChat on mental health & #veterans with #PTSD with Dr. Brendel of @homebaseprogram & @miller7 is about to begin! #AHRQIX
AHRQIX: @MakeItVisible Thanks for spreading the word. We're chatting now, feel free to jump in! #AHRQIX
miller7: @homebaseprogram Recognizing the financial challenges, are there other creative ways to financially sustain these programs? #ahrqix
homebaseprogram: Our vet team is greatest asset. Seeing another vet puts a patient immediately at ease and establishes #trust @miller7 @nickdawson #ahrqix
mlottmanier: @miller7 Vets often find peer services outside of military system- sober active communities, comm. health centers, churches #AHRQIX
VAHthInnovation: .@nickdawson Agree. Va DHP is updating their crosswalk to better match skilled vets with appropriate civilian health professions. #AHRQIX
homebaseprogram: In addition to philantrhropic donors we also are always looking for grants & other opportunities to improve care nation-wide @miller7 #ahrqix
miller7: What are the signs and symptoms to watch for when a service member returns home from combat? #AHRQIX
AHRQAcademy: Take a look at some resources regarding #PTSD in #primarycare: ptsd.va.gov/professional/p… #AHRQIX @homebaseprogram
AHRQIX: This @VeteransHealth group support program enhanced skills & reduced burden & depression for caregivers go.usa.gov/bjeY #AHRQIX
homebaseprogram: Symptoms #PTS #TBI #invisiblewounds include trouble sleeping, anxiety, difficulty concentrating,feeling numb, irritability #ahrqix @miller7
mlottmanier: Lack of govt $ for vet peer services has led to Nat'l Guard, reservist vets now in civilian life finding alternative supports #AHRQIX
homebaseprogram: @RAND estimates 50% vets seek care in community @mlottmanier #ahrqix
miller7: Is there a normal time period of readjustment when returning from deployment? #AHRQIX
AHRQIX: MT @homebaseprogram: @RANDCorporation estimates 50% vets seek care in community @mlottmanier #ahrqix
homebaseprogram: Usually, if still experiencing symptoms 3 months after return #deployment seek care prolonged symptoms can interfere w/ your life #ahrqix
miller7: When is it time to pick up the phone and call Home Base to ask for help? @homebaseprogram #AHRQIX
AHRQIX: These videos help mental health providers prevent problems resulting from warzone stress go.usa.gov/bjuR via @DeptVetAffairs #AHRQIX
homebaseprogram: Treatment works – the sooner you ask for help, the quicker you can conquer symptoms #ahrqix
MsWZ: RT @AHRQIX: These videos help mental health providers prevent problems resulting from war zone stress go.usa.gov/bjuR via @DeptVetAff…
miller7: What are the challenges of treating post-traumatic stress & with the presence of a mild traumatic brain injury (TBI)? #AHRQIX
homebaseprogram: First challenge is diagnosis - symptoms overlap incl. depression, irritability, sleep difficulty, concentration & mem prob. @miller7 #ahrqix
miller7: @homebaseprogram for individuals looking to learn more about #ptsd assessment, what websites or resources would you recommend? #ahrqix
mlottmanier: @homebaseprogram #AHRQIX mental health center Aspen Pointe in COSprings developed a peer navigator program for vets: bit.ly/11vT8cm
homebaseprogram: In treatment, critical to figure out cause symptoms treat both #PTS and #TBI concurrently @miller7 #ahrqix
AHRQIX: Here's a pocket guide for managing #PTSD & ASR via @DeptofDefense @DeptVetAffairs @VeteransHealth go.usa.gov/bjhx #AHRQIX
homebaseprogram: Do you have symptoms? Visit our website for #selfassessment homebaseprogram.org/questionnaires… @miller7 #ahrqix
AHRQIX: RT @homebaseprogram: Do you have symptoms? Visit our website for #selfassessment homebaseprogram.org/questionnaires… @miller7 #ahrqix
miller7: How can reintegration challenges affect other members of the family? #AHRQIX
AHRQIX: .@VeteransHealth's Care Coordination/Home Telehealth Program uses remote monitoring to reduce hospital visits go.usa.gov/bjtj #AHRQIX
homebaseprogram: We support family too bc, “when one member of the family serves, the entire family serves” visit bit.ly/NMAyJ8 #ahrqix @miller7
miller7: @homebaseprogram: We support family too bc, “when one member of the family serves, the entire family serves” bit.ly/NMAyJ8 #ahrqix
miller7: Dr. Brendel, who are some of the community partners that you work with at Home Base to reach the veteran population? #AHRQIX
atyreefinch: Are different conflicts associated w/ different types of PTSD? I.e. Do Viet Nam & Gulf War vets w/ PTSD have any different symptoms? #AHRQIX
homebaseprogram: We work w/ @MADVS @BostonVets @VABostonHC @VA_PTSD_Info - for full list #partners visit bit.ly/12GI80w #ahrqix @miller7 #ahrqix
homebaseprogram: Also @MANationalGuard @NavyMedicine @AirNatlGuard @MassGeneralNews @SpauldingRehab @miller7 #ahrqix
MLibraryHealthy: RT @AHRQIX: Here's a pocket guide for managing #PTSD & ASR via @DeptofDefense @DeptVetAffairs @VeteransHealth go.usa.gov/bjhx #AHRQIX
AHRQIX: This @AoAgov program gives Medicaid enrollees an allowance for home care, resulting in fewer unmet needs go.usa.gov/bjse #AHRQIX
homebaseprogram: The core criteria are similar and include exposure, re-experiencing, hyper-arousal, and avoidance @atyreefinch #ahrqix
miller7: What about to reach clinicians and other first responders in the community? #AHRQIX
homebaseprogram: We create a care network through #trainings, visit bit.ly/NAoM1o for our #war zone series bit.ly/Yi3nQs #ahrqix @miller7
miller7: What are some of the tools and resources available that #healthcare systems or clinicians should know about? #AHRQIX
AHRQIX: Regular patient & staff meetings reduce violence episodes by 85% on the inpatient psych unit @VeteransHealth go.usa.gov/bjMT #AHRQIX
homebaseprogram: #clinicians see stayingstrong.org homebaseprogram.org bit.ly/Yi3nQs bit.ly/115dffK @miller7 #ahrqix
AHRQIX: We’ll be closing the live chat in 10 mins but will continue to answer the questions that come in before 1pm #AHRQIX
miller7: Participants, please share with us some of the resources that you have used in your clinical practices and areas of work. #AHRQIX
homebaseprogram: Watch this video of #BeetleBailey with #PTS by cartoonist @mortwalker bit.ly/10uatqH part of our new awareness campaign #ahrqix
AHRQIX: RT @homebaseprogram: Watch this video of #BeetleBailey with #PTS by cartoonist @mortwalker bit.ly/10uatqH part of our new awareness…
AHRQIX: Thank you to everyone who joined & participated in our TweetChat today! You can review the archive using #AHRQIX after the event
AHRQIX: Feel free to continue sharing questions, info, and what’s working for you via Twitter to @AHRQIX, @homebaseprogram &/or @milller7 #AHRQIX
AHRQIX: And a special thanks to Dr. Brendel & @miller7! We’re so glad you were both able to join us today! @homebaseprogram #AHRQIX
homebaseprogram: More Questions? Contact Home Base by calling 617-724-5202 or visit homebaseprogram.org email homebaseprogram@partners.org #ahrqix
AHRQIX: RT @homebaseprogram: More Questions? Contact Home Base by calling 617-724-5202 or visit homebaseprogram.org email homebaseprogram@partne…
AHRQIX: To learn more about AHRQ Health Care Innovations Exchange, visit the ‘About’ section of our website: go.usa.gov/7vW #AHRQIX
TJStGeorge: RT @homebaseprogram: We treat vets & families for comprehensive evaluation and care regardless of discharge status or ability to pay #ahrqix
TJStGeorge: RT @homebaseprogram: 1 in 3 veterans returns w/ #PTS or #TBI and “for every warrior there are 10 worriers” back home. - we treat both vet …
MsWZ: RT @homebaseprogram: More Questions? Contact Home Base by calling 617-724-5202 or visit homebaseprogram.org email homebaseprogram@partne…
El_Connolly: RT @homebaseprogram: Watch this video of #BeetleBailey with #PTS by cartoonist @mortwalker bit.ly/10uatqH part of our new awareness…
miller7: MT @tomcampbellric: @nickdawson unique group w/ unique needs. Providers need cultural competence (military culture) to be effective #AHRQIX
DocForeman: @AHRQIX @VeteransHealth Relationships with the #Veterans we serve can reduce “violence episodes” also hospitalizations and suicide. #AHRQIX
DocForeman: @atyreefinch Sxs similar, IMHO, but how they view the Sxs and view their service is VERY different. Can create cohort divides. #AHRQIX
DocForeman: @miller7 Adjusting to a new normal, new habits, new MH Sxs, economic struggles, new schedules, etc. #AHRQIX
DocForeman: @homebaseprogram @miller7 Yes. Also challenge to resist labelling every Sx PTSD (which is more “accepted” Dx for several reasons). #AHRQIX
DocForeman: @miller7 This is hard to put in 1 tweet. TBI can affect executive functioning, impulsivity, create new beh. problems. And… #AHRQIX
DocForeman: @miller7 Plus, many things Vets might do to cope with TBI can complicate PTSD and other MH issues (Substance use, for example). #AHRQIX
DocForeman: @miller7 Also, many Vets with TBI also have other injury, pain, chronic headaches, poor sleep, which adds further complexity to Tx. #AHRQIX
DocForeman: @mlottmanier I am doing a lot now at my VA to be well-connected w/ Nat'l Guard community. Huge need for help w/ MH referrals. #AHRQIX
DocForeman: RT @homebaseprogram: 1 in 3 veterans returns w/ #PTS or #TBI and “for every warrior there are 10 worriers” back home. - we treat both vet …
DocForeman: @SurGlobalLatta @mlottmanier Yes. That definitely happens. It really helps to figure out where the advocacy and pt. support is. #AHRQIX
SurGlobalLatta: @DocForeman @mlottmanier Depression often keeps pts from doing exactly what they need to do to improve their dysthymic world.Cycle. #AHRQIX
miller7: @DocForeman Thanks for the comments, Doc! This is very helpful!! #AHRQIX
AHRQIX: @DocForeman So sorry you missed the chat, but thanks for sharing all your great insights! Lots of great info in there! #AHRQIX
ProfAmyE: RT @AHRQIX: These videos help mental health providers prevent problems resulting from war zone stress go.usa.gov/bjuR via @DeptVetAff…
cherylholt: RT @AHRQIX: Coordinating mental health & primary care improves engagement go.usa.gov/bjHV @Harvard @samhsagov @Penn @DeptVetAffairs …
BHPCIntegration: RT @AHRQIX: Coordinating mental health & primary care improves engagement go.usa.gov/bjHV @Harvard @samhsagov @Penn @DeptVetAffairs …

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