AHEC Project for the Behavioral Health of Veterans, Service ...

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The toolkit includes fully developed curricula for one-hour and four-hour trainings with agendas, slides, speaker notes, and handouts that have been pre-approved by the Post- Graduate Institute for Medicine (PIM) for 1 and 4 hours’ credit respectively for physicians, nurses, social workers, marriage counselors, and family therapists. This option was developed to streamline the process of getting CE credit for these programs for all participating centers and especially for those with limited experience and resources in this area. Centers choosing to provide credit through PIM can do so through an expedited process and for a $500 fee. The toolkit minimizes the number of staff and the amount of time and resource investment needed to offer these trainings so that all AHEC centers have the resources needed in order to participate. A-TrACC developed AHEC-specific evaluation tools and methods to determine the effectiveness of the “Train-the- Trainer” workshops and the resulting CE programming on improving the competency and practice of healthcare providers. The evaluation process and tools were approved by the Office of Management and Budget in July 2012. The evaluation methodology for this project includes commitment to complete assessments both at the immediate conclusion of a CE offering and again within 30 days after the offering through a brief follow-up e-mail survey implemented by AHEC staff with a randomly selected sample of 2% of participants. For each CE offering, AHEC staff compiles and submits a final report of aggregate responses to A-TrACC. Conclusion By the end of the first year of the project on September 29, 2012, AHECs trained over 2,700 health professional participants. A number of AHECs that were new to providing CE were able to participate in the project and anecdotal evidence about their participation is encouraging. Many AHECs reported building new partnerships through the project and noted an overwhelming appreciation for the training from their participants. While several AHEC centers reported barriers to the effectiveness of their training, A-TrACC provides ongoing individualized technical assistance aimed at overcoming these challenges. HRSA and A-TrACC are continuing this important project over the next contract year (September 2012-September 2013) and will be providing more resources, trainings, and technical assistance to support AHEC Programs and Centers in carrying out this project. Kyle Peplinski, MA, is HRSA Project Officer, AHEC Training and Consultation Center (A-TrACC) Public Health Analyst, U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions Carol Trono, MA, is Program Manager, AHEC Training and Consultation Center (A-TrACC) Coordinator II, and Texas AHEC East. Gretchen Forsell, MPH, RD, LMNT, is Project Manager, AHEC Training and Consultation Center (A-TrACC) and Executive Director of the Northern Nebraska AHEC. Sheryl Pacelli, MEd, is Consultant, National AHEC Organization Veterans Mental Health Project and Pace Consulting and Associates. Mary Wainwright, MS, RN, is Director, AHEC Training and Consultation Center (A-TrACC) and Deputy Director of the Texas AHEC East. REFERENCES Brancu, M., Straits-Tröster, K., & Kudler, H. (2011). Behavioral health conditions among military personnel and veterans: Prevalence and best practices for treatment. North Carolina Medical Journal, 72(1): 54-60. Cohen, B. E., Gima, K., Bertenthal, D., Kim, S., Marmar, C. R., & Seal, K. H. (2010). Mental health diagnoses and utilization of VA non-mental health medical services among returning Iraq and Afghanistan veterans. Journal of General Internal Medicine, 25(1): 18-24. Seal, K. H., Metzler, T. J., Gima, K. S., Bertenthal, D., Maguen, S., & Marmar, C. R. (2009). Trends and risk factors for mental health diagnoses among Iraq and Afghanistan veterans using Department of Veterans Affairs health care, 2002-2008. American Journal of Public Health, 99(9): 1651-1658. 8 nationalAHEC.org
Serving Those Who Have Served: Educating Community Healthcare Providers Working with Service Members, Veterans, and Their Families Bennie Pettit and Fay Brown Nathan “Nate” Moore understands the importance of well-trained community healthcare professionals who serve wounded warriors and their families. Two years of therapy in his Greenville, South Carolina community helped the veteran of combat in Afghanistan and Iraq overcome severe injuries and hold his family together. Nate’s story is commonplace, yet no less heart-wrenching and life-changing. During a 2009 seven-month tour of duty in Afghanistan, the Marine infantry regiment team leader suffered four severe concussions during a 20-hour firefight. Determined not to abandon his fellow Marines, the Combat Engineer, whose job it was to search for improvised explosive devices (IEDs), kept returning to the field after each injury, striving to keep his men alive. Following the battle, Nate was medically evacuated and received treatment at his small local base, then spent three months receiving treatment at a larger base in Afghanistan. He returned home medically retired. Attempting to re-enter his life as he left it in Greenville, Nate realized he needed additional help. He suffered from Post-Traumatic Stress Disorder (PTSD), traumatic brain injury, and post-concussion syndrome. His memory was gone, his ability to think and reason had left him, and his relationship with his wife was disintegrating as his illnesses became more severe. Seven months of treatment in Charlottesville, Virginia provided help for Nate’s recovery, but the separation from his family was harmful. “It was like being deployed once again,” Nate says. Once back in Greenville, he contacted Major Charlie Hall, a West Point grad and Marine Corps non-medical case manager for post-9/11 combat vets in South Carolina and nationalAHEC.org Georgia. Major Hall arranged for Nate to receive therapy through a local rehabilitation hospital. For two years Nate faithfully attended local therapy sessions, and his wife received therapeutic help as well, learning about PTSD and Nate’s sometimes misunderstood behavior. “Local therapy is awesome,” Nate responds gratefully. “Our family is together now. Family members need PTSD education and therapy, too, not just the veteran. Spouses can be traumatized when receiving news their loved one is injured. I am thankful my wife was able to get help.” Nate credits his outstanding local therapists for his life today. Life is good. So good in fact, that the Moores welcomed their first child in early December, a baby boy, Connor, and look forward to a wonderful future together as a recovered wounded warrior family. Nate’s story was shared in trainings provided to a wide variety of civilian community healthcare professionals in Upstate South Carolina. Partnering with the National AHEC Organization, Health Resources and Services Administration, and the Greenville Veterans Administration Outpatient Clinic, Upstate AHEC in Greenville sponsored two continuing education opportunities entitled, “Serving Those Who Have Served: Educating Community Healthcare Providers Working with Service Members, Veterans and Their Families,” which was designed for civilian licensed mental health providers including primary care providers, psychologists, social workers, psychiatrists, licensed nurses, marriage and family therapists, and other healthcare professionals who provide services to military personnel, veterans, and their families or who plan to actively treat wounded warriors. The purpose of the continuing education program was to increase knowledge and improve diagnosis and treatment practices for civilian healthcare professionals who treat veterans with behavioral/mental health issues; to better understand the military culture of veterans, service members and their families; and to During Upstate (SC) AHEC’s training for healthcare providers in July 2012, more than 80 participants heard veterans’ testimonials of their mental health struggles after returning from Iraq and Afghanistan. 9
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