VA For Vets: MENTAL HEALTH HIRING INITIATIVE

 VA Announces Aggressive National Recruitment Effort to Hire Mental Health Professionals

WASHINGTON - Secretary of Veterans Affairs Eric K. Shinseki recently announced the department would add approximately 1,600 mental health clinicians as well as nearly 300 support staff to its existing workforce to help meet the increased demand for mental health services.  The Veterans Health Administration (VHA) has developed an aggressive national recruitment program to implement the hiring process quickly and efficiently.

“The mental health and well-being of our brave men and women who have served the Nation is the highest priority for this department,” said Secretary Shinseki.  “We must ensure that all Veterans seeking mental health care have access to timely, responsive and high-quality care.”

 

VA has developed an aggressive national mental health hiring initiative to improve recruitment and hiring, marketing, education and training programs, and retention efforts for mental health professionals, to include targeted recruitment in rural and highly-rural markets. This will help VA to meet existing and future demands of mental health care services in an integrated collaborative team environment and continue to position VA as an exemplary workplace for mental health care professionals.

 

It is critical for VA to proactively engage psychiatrists and other mental health care providers about the vital mission to deliver high-quality mental health services, especially for returning combat Veterans.

 

“The VA mental health community is aggressively transforming the way mental health care services are provided to the Veteran population. As the mental health care workforce continues to increase, VA is committed to improving Veterans’ access to services, especially for at-risk Veterans,” said VA’s Under Secretary for Health Dr. Robert Petzel. 

 

The national recruitment program provides VHA with an in-house team of highly skilled professional recruiters employing private sector best practices to fill the agency’s most mission critical clinical and executive positions.  The recruitment team consists of 21 national, dedicated health care recruiters targeting physician and specialty health care occupations. These recruiters also understand the needs of Veterans because each member is a Veteran. 

 

VHA has also established a hiring and tracking task force to provide oversight for this initiative to move the process forward expeditiously in a focused manner to ensure challenges, issues, or concerns are addressed and resolved.  This task force is accountable for reporting progress in hiring of mental health professionals in these occupations: psychiatrists, psychologists, mental health nurses, social workers, mental health technicians, marriage and family therapists and licensed professional counselors.

 

VHA anticipates the majority of hires will be selected within approximately six months and the most “hard-to-fill” positions filled by the end of the second quarter of FY 2013. VA has an existing workforce of 20,590 mental health staff that includes nurses, psychiatrists, psychologists, and social workers.

 

Interested mental health care providers can find additional information about VA careers and apply for jobs online at www.vacareers.va.gov.  To locate the nearest VA facility or Vet Center for enrollment and to get scheduled for care, Veterans can visit VA’s website at www.va.gov.  Immediate help is available at www.VeteransCrisisLine.net or by calling the Crisis Line at 1-800-273-8255 (push 1) or texting 838255.

Military Mental Health Crisis Exposed with Camp Liberty Killings

By ELLIOT BLAIR SMITH 

Bloomberg News

Published: August 2, 2012

Sergeant John Russell lay awake, wondering what his wife would do if he killed himself.

He was so messed up that his first lieutenant removed the firing pin from his M16 assault rifle. Six weeks from the end of his fifth combat-zone tour, and five years from retiring on a 20-year Army pension, he suspected he wouldn’t see any of it.

Before dawn, shaking and stuttering, Russell walked through the still desert outside Baghdad to the quarters of Captain Peter Keough, the 54th Engineer Battalion’s chaplain. Keough listened, and hastily made the sergeant’s fourth appointment in four days at an Army mental-health clinic.

“I believe he is deteriorating,” Keough e-mailed an Army psychiatrist. “He doesn’t trust anyone.” Russell, the chaplain wrote, “believes he is better off dead.”

It was 10:07 a.m. on May 11, 2009. The battalion, military police and combat stress specialists had three hours and 34 minutes to avert tragedy. Instead, after lost opportunities and miscalculations, the blue-eyed sergeant from Texas used a stolen gun to kill three enlisted men and two officers in the deadliest case of soldier-on-soldier violence in the war zone. His victims’ bodies are buried across the U.S., from Arlington National Cemetery to the Texas panhandle.

Russell slipped through the safety net constructed to catch troubled soldiers. More and more are falling. The armed services’ mental-health epidemic has deepened since the Camp Liberty killings. In June, Defense Secretary Leon Panetta ordered a Pentagon review of every diagnosis from 2001 on.

Court Martial

“The military and the nation were not prepared for the mental-health needs from being in combat for more than a decade,” said retired Colonel Elspeth Ritchie, the top psychiatric official in the Army’s Office of the Surgeon General from 2005 to 2010, in an interview. “We now confront ourselves with a mental-health crisis that is a legacy of war.”

Prosecutors paint the 6-foot, 4-inch (1.9-meter) Russell as a cold-blooded killer, cunning enough to slip through a back door into a mental-health clinic where he mowed down unarmed men. His lawyers contend that he’s not guilty by reason of insanity, undone by repeat deployments and misdiagnosed in that same clinic.

His hands and feet shackled, Russell said in an interview that he doesn’t remember much about that day three years ago. He’s awaiting court martial at Joint Base Lewis-McChord in the shadow of Mount Rainier in Washington.

Military Life

The Army decided May 15 to seek the death penalty on five counts of premeditated murder, overruling the recommendation at a pre-trial hearing that Russell’s “undisputed mental disease or defect” made that punishment inappropriate.

“It scares me,” Russell said.

Prosecutors declined to comment. This account is based on thousands of pages of Army records, civilian documents obtained with public records requests and more than two dozen interviews.......

MORE HERE: http://www.stripes.com/news/special-reports/post-traumatic-stress-disorder-ptsd/military-mental-health-crisis-exposed-with-camp-liberty-killings-1.184668?localLinksEnabled=false

LEGISLATIVE UPDATE: Over 50 Pieces of Veterans Legislation sent to President To Be Signed Into Law

WASHINGTON, D.C.—Last night, the House of Representatives unanimously passed the Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012 (H.R. 1627). The bill, now headed to the President for signature into law, will bring immediate VA healthcare to Camp Lejeune veterans and their families who have been diagnosed with a disease related to the water contamination that occurred at the base between 1957 and 1987. In addition, H.R. 1627 increases VA accountability to veterans by streamlining the disability claims process, ensuring transparency in VA funding, protecting veterans from sexual assault, and transforming how VA does business in the 21st century.

“This legislation is a culmination of more than a year’s worth of work on behalf of America’s veterans, and an example of what lawmakers can accomplish working together in a bipartisan manner,” stated Rep. Jeff Miller, Chairman of the House Committee on Veterans’ Affairs. “The Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012 will make an immediate impact in the lives of veterans, their families, and survivors by providing the care and support they have earned through their service to our nation.”

“I am pleased that the House of Representatives came together in a bipartisan manner to support H.R. 1627, which included legislation I authored to help streamline the claims process for our veterans,” stated Rep. Jon Runyan, Chairman of the Subcommittee on Disability Assistance and Memorial Affairs. “Our veterans have sacrificed so much and it is an outrage that many have to wait months for benefits claims to be processed. The backlog at VA must be addressed and fixed, and I believe the passage of this bill is an important first step. I look forward to continuing my work to ensure the backlog is eliminated.”

“Every year, VA spends millions of dollars on conferences and, while there is a need for such meetings, Congress must be able to provide proper oversight of this spending. I’m proud that this legislation will require VA to report on conferences costing $20,000 or more,” stated Rep. Marlin Stutzman, Chairman of the Subcommittee on Economic Opportunity. “Transparency and accountability are essential as VA conducts its mission to serve our veterans.”  

“Caring for our nation’s veterans and their families is one of our most crucial duties as legislators. I am especially pleased that the Veterans Sexual Assault Prevention and Health Care Enhancement Act is part of this legislation and will be sent to the President for consideration,” stated Rep. Ann Marie Buerkle, Chairwoman of the Subcommittee on Health. “Negligence related to sexual assault within the VA cannot be tolerated. This legislation will correct a fundamental weakness in VA’s system by setting in place the procedures and accountability measures necessary to ensure the protection of veterans and staff.”

“America’s veterans deserve the very best of the benefits and care they have earned, and VA consistently falls short when it comes to addressing the needs of our heroes. More than half of disability claims have been pending for more than 125 days and the backlog has surged to more than 900,000 claims,” stated Rep. Bill Johnson, Chairman of Subcommittee on Oversight & Investigations. “This is completely unacceptable. The Modernizing Notice to Claimants Act, included in H.R. 1627, which I introduced, will modernize how VA communicates with claimants while holding VA’s feet to the fire in making sure America’s veterans are being properly served by VA.”

To learn more about the Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012, click: http://veterans.house.gov/hr1627

Army to stop using forensic psychiatrists to evaluate soldiers diagnosed with PTSD

By HAL BERNTON

The Seattle Times

Published: August 1, 2012

RELATED

• Stars and Stripes coverage of PTSD

COURTESY OF DVIDS

The Army no longer will use forensic psychiatrists to evaluate soldiers diagnosed with post-traumatic stress disorder and under consideration for medical retirement, a change resulting from an investigation of a screening team at Madigan Army Medical Center.

"What we found is that the forensic methods are not the right ones for the United States Army disability evaluation system," Gen. Lloyd Austin, the Army's vice chief of staff, said in a statement Tuesday. "We learned MAMC (Madigan) officials acted in accordance with the standard of practice for civilian disability evaluations. But we also learned that while the evaluation may be fair and appropriate, it's simply not optimal for the unique cases that the Army diagnoses and reviews. We've fixed that."

The Army on Tuesday also reinstated Madigan's commander, Col. Dallas Homas, who was suspended this year as the investigation got under way at the medical center on Joint Base Lewis-McChord, south of Tacoma.

Austin said Homas, who came to Madigan in 2011, did not exert undue influence on PTSD diagnoses and is back on the job.

"Col. Homas began his tenure ... at a critical juncture, as the hospital faced a massive deficit, declining numbers of patients served, and other organizational problems," Austin said. "His leadership was important to improving (Madigan)."

The Army investigation of Madigan focused on the conduct of the forensic team, whose screening of patients under consideration for medical retirement once was touted by Madigan leaders as a "best practice."

Forensic evaluations often are used in legal proceedings and typically include administering tests such as the Minnesota Multiphasic Personality Inventory, which at Madigan was used sometimes to assess the severity of PTSD symptoms or whether a soldier might be feigning symptoms.

The Madigan forensic team ended up overturning the PTSD diagnoses of more than 300 service members who were under consideration for a retirement that would qualify them for a pension and other benefits.

The Madigan forensic team's work triggered complaints from patients, some of whom were tagged as possible malingerers.

These complaints drew scrutiny from an Army Medical Command ombudsman. The ombudsman, in a memorandum, noted that a forensic team member gave a talk during which he cited the need to be good stewards of taxpayer dollars because a medical retirement provides up to $1.5 million in benefits over a soldier's life.

U.S. Sen. Patty Murray, D-Wash., who chairs the Senate Committee on Veterans Affairs, also fielded complaints from soldiers.

In February, the Army surgeon general, Lt. Gen. Patricia Horoho, announced an investigation of Madigan's mental-health screening, suspending the forensic team from its evaluation duties and putting together a new group to re-evaluate the claims of patients whose PTSD diagnoses had been overturned.

Army investigators also were to examine why Madigan closed an intensive outpatient PTSD program.

The Seattle Times has requested a copy of the Madigan investigation of the forensic team under the federal Freedom of Information Act, as well as other investigations launched this year at Madigan.

The Army has not released these reports. A spokesman from Murray's office said the senator has not obtained them.

The progress of the Madigan re-evaluations of patients also was not disclosed in the statement released Tuesday.

MORE HERE: http://www.stripes.com/news/special-reports/post-traumatic-stress-disorder-ptsd/army-to-stop-using-forensic-psychiatrists-to-evaluate-soldiers-diagnosed-with-ptsd-1.184570

Radiology: fMRI showcases brain’s resilience after mild TBI

Written by Evan Godt   

July 30, 2012

In patients who have sustained mild traumatic brain injury (MTBI), differences in working memory functional activity were observed with MRI even though patients performed as well as controls on working memory tests, according to a study published online July 24 inRadiology.

Study authors Chi-Jen Chen, MD, of Taipei Medical University/Shuang Ho Hospital in New Taipei City, Taiwan, and colleagues said the results indicated the inclusion of MR imaging evaluation may increase sensitivity to MTBI compared with neuropsychological evaluation alone.

“This study determined that, despite no apparent differences in neuropsychological tests, brain activation patterns differed between MTBI patients and control subjects in response to increasing working memory loads,” wrote the authors.

A total of 20 patients with MTBI and 18 healthy control subjects were included in the study. Subjects were given n-back continuous performance tests, and functional MRI was used to asssess brain activation patterns in response to the tests. In the MTBI group, imaging was conducted within one month after injury.

N-back working memory tasks are conducted by presenting subjects with a sequence of stimuli, and the subjects are tasked with indicating when the current stimulus matches one from a certain number of steps earlier in the sequence. In the current study, subjects were given one-back, two-back and three-back tests in which they monitored a series of numbers and indicated when the current number matched a previous number from one, two or three steps prior, respectively.

Chen et al reported that the study groups performed similarly well on the n-back working memory tasks. The groups were statistically similar for sex, years of education and performance on a digit span memory test in which subjects were asked to remember an entire sequence of numbers.

Brain activation patterns differed between subjects, with controls able to increase activation in working memory circuitry as the working memory load required for the tasks increased. “In contrast, MTBI patients were impaired in their ability to increase activation in working memory circuitry under both moderate and high working memory load conditions,” wrote the authors. “However, MTBI patients did show cerebral plasticity, as evidenced by more activation in some areas outside and inside the working memory circuitry as compared with control subjects.”







COMPLETE STORY HERE: http://www.healthimaging.com/index.php?option=com_articles&view=article&id=34700:radiology-fmri-showcases-brains-resilience-after-mild-tbi