1549.01388.386241140001https://myrebeldiaries.com01
theme-sticky-logo-alt

Mental Health

0 Comments

Hits: 1

Some of the links on this website are affiliate links, and that means we may earn a commission if you click or purchase through those links. The price you pay will be the same, but by using our affiliate links you are helping support our website. We genuinely appreciate your support. Thank you!


VA research on

Mental Health

Introduction

Mental health conditions are common in the United States. According to the National Institute of Mental Health, nearly one in five U.S. adults live with a mental illness (46.6 million in 2017). More than 1.7 million Veterans received treatment in a VA mental health specialty program in fiscal year 2018.

VA offers a wide range of mental health services to Veterans. The goal of VA mental health care is to support recovery and enable Veterans who experience mental health problems to live meaningful lives in their communities and achieve their full potential.

The department aims to provide coordinated care for the whole person, not just for the person’s mental illness. VA promotes the idea that having a healthy body, satisfying work, and supportive family and friends are integral to mental health. All Veterans who receive specialty mental health care have mental health treatment coordinators to help them define and work toward their overall mental health goals.

Mental health services are available in VA’s mental health specialty clinics, primary care clinics, nursing homes, and residential care facilities. At most of VA’s larger primary care venues, VA now integrates mental health staff into Patient Aligned Care Teams (PACTs), allowing those care teams to provide services for depression, anxiety, posttraumatic stress disorder (PTSD), and substance use without needing a separate consult with mental health providers outside of the PACT clinic area. Those with serious mental health problems may take part in specialized programs such as mental health intensive case management, day centers, work programs, and psychosocial rehabilitation.

Emergency mental health care is available 24 hours a day, seven days a week at VA medical centers. Facilities that do not have 24-hour emergency rooms must provide emergency services through a local non-VA hospital.

Veterans thinking about hurting or killing themselves or others, experiencing an emotional crisis, feeling hopeless, or engaging in self-destructive behavior such as drug abuse should call the Veterans Crisis Line at 1-800-273-TALK (8255). Press 1 for Veterans.

top

Selected Major Accomplishments in VA Research

  • 1941: Set up a research lab at the Northport VA Medical Center, to conduct clinical and biomedical research in neuropsychiatric disorders
  • 1989: Created the National Center for PTSD to address the needs of Veterans and other trauma survivors with PTSD
  • 1997: Identified a gene associated with a major risk for schizophrenia
  • 2003: Determined that while atypical antipsychotic drugs vary in cost, there is limited evidence of differences in effectiveness
  • 2006: Developed, through VA’s TIDES project, an evidence-based collaborative approach to depression management
  • 2013:
  • Determined an association between homelessness among Veterans and childhood problems such as abuse and family instability
  • Found that a loss of gray matter in three separate brain structures is common across a spectrum of psychiatric disorders widely perceived to be distinct
  • 2016: Found that the use of an injectable antipsychotic led to significant cost-savings related to inpatient admissions of patients with schizophrenia compared to oral atypical antipsychotics
  • 2017: Learned that compensatory cognitive training (CCT) can improve thinking ability, psychiatric symptoms, and quality of life in people with severe mental illnesses

top

New, Ongoing, and Published Research

VA researchers are looking at potential new approaches for treating and preventing mental health disorders. They are also working on related projects such as developing and evaluating collaborative primary care models and improving access to services from rural and other remote areas by using the internet and other technologies.

Among the areas VA researchers are focusing on are mood disorders, such as depression and bipolar disorder; psychotic disorders, such as schizophrenia; PTSD and other anxiety conditions; and substance use disorders. VA investigators are highly organized in identifying, testing, and confirming new treatments for PTSD, especially focused on medications through the PTSD Psychopharmacology Initiative.

VA investigators are also looking at the co-occurrence of mental health issues and physical disorders—for instance, depression in those with spinal cord injury, or substance use disorder in patients with chronic pain.

The National Research Action Plan is a wide-reaching plan developed in 2013 by VA and the departments of Defense, Health and Human Services, and Education. The plan is designed to improve access to mental health services for Veterans, service members, and military families.

Implementation of the plan will improve scientific understanding of PTSD, traumatic brain injury (TBI), various co-occurring conditions, and suicide. Other goals of the plan include providing effective treatments for these diseases and reducing their occurrence.

VA’s 15 Mental Illness Research, Education and Clinical Centers (MIRECCs) research the causes and treatments of mental disorders and use education to put new knowledge into routine clinical practice in VA. Specialized mental health centers of excellence are an essential part of VA’s ability to meet Veterans’ mental health needs.

VA’s Center for Integrated Health Care, located in Canandaigua, New York, is dedicated to advancing research, education, and clinical consultation to enhance the integration of mental health and primary care services for Veterans. The Center of Excellence for Suicide Prevention, also located in Canandaigua, integrates surveillance with intervention development to inform the implementation of effective suicide prevention strategies for Veterans.

The Center of Excellence for Research on Returning War Veterans in Waco, Texas, supports state-of-the-art research on the effects of combat exposure on mental health. Center researchers focus on preventing mental illness in Iraq and Afghanistan Veterans and providing treatment and rehabilitation for those with mental illnesses.

The Center of Excellence for Stress and Mental Health, in San Diego, works to understand the neurobiological mechanisms of responses to trauma and, through this understanding, to develop and disseminate novel, effective treatments.

VA’s National Center for PTSD is a VA group of research centers that focus entirely on the condition.

The department’s Center for Mental Healthcare and Outcomes Research, in North Little Rock, Arkansas, conducts research to improve access to and engagement in evidence-based mental health and substance use care. The Brain Rehabilitation Research Center, in Gainesville, Florida, develops and tests treatments to substantially improve or restore motor, cognitive, and emotional functions that have been impaired by neurologic disease or injury. The Translational Research Center for TBI and Stress Disorders (TRACTS), in Boston, studies the complex changes in the brain, thinking, and psychological well-being that result from traumatic brain injury and PTSD.

Two of VA’s 10 Collaborative Research to Enhance and Advance Transformation and Excellence (CREATE) programs address issues important to mental health. The primary goal of the Evidence-Based Therapies for PTSD CREATE is to improve Veterans’ access to and engagement in evidence-based treatments for PTSD. The Improving Rural Veterans’ Access/Engagement in Evidence-based Mental Healthcare CREATE aims to improve treatment engagement for Veterans living in rural settings who use mental health services at VA community-based outpatient clinics.

VA’s Quality Enhancement Research Initiative (QUERI) for Team-Based Behavioral Health, located in Little Rock, works to improve coordination, quality, equality, and outcomes of team-based care for Veterans with behavioral health conditions. This QUERI team is looking at ways to use measurements in mental health care—for example, having Veterans complete some kind of assessment of their mental health status each and every time they visit a VA mental health practitioner, to provide a score that can be tracked over time. The Virtual Specialty Care QUERI Program is comparing implementation strategies through telemedicine outreach for PTSD to increase Veterans’ access to PTSD services.

top

Anxiety disorders

Anxiety is a normal biological reaction to a stressful event. For some people, however, their anxiety does not go away and may even worsen over time. They can experience symptoms such as nightmares, a racing pulse, and excessive worry or fear. In persistent cases, anxiety disorders such as PTSD, panic disorders, and phobias may develop.

Older Veterans no more likely to have anxiety than non-Veterans—In 2014, a team from the VA Palo Alto Health Care System and Stanford University School of Medicine examined data on 7,000 men age 50 or older, and found that Veterans were no more likely than non-Veterans to have depression or anxiety.

Because Veterans, especially those who served in combat, have generally experienced more stress and trauma in their lives than non-Veterans, the team had expected to see higher rates of depression among Veterans. Instead, they found just the opposite. Older Veterans actually scored better than non-Veterans in the same age group.

The team found 11 percent of Veterans reported elevated rates of depression, compared with 12.8 percent of non-Veterans. For anxiety, 9.9 percent of Veterans reported elevated levels, versus 12.3 percent for non-Veterans. These differences were not considered statistically significant.

Vietnam Veterans, however, were twice as likely to have elevated depression and anxiety, compared with World War II or Korean War Veterans in the study. The team said further studies are needed to explain this finding.

Anxiety sensitivity may link PTSD and suicide risk—Anxiety sensitivity is an exaggerated fear of experiencing symptoms related to anxiety, separate from the actual symptoms. In 2017, researchers at the Southeast Louisiana Veterans Health Care System found a significant association between the severity of PTSD in 60 male Veterans and a greater frequency of suicidal thoughts, plans, and impulses. They also found that cognitive anxiety sensitivity concerns may be responsible for this link—meaning that when people with PTSD worry that their personalities have changed or that they are not thinking normally, they may be at increased risk of suicidal behavior.

Relationship of PTSD and anxiety disorders to homelessness—Researchers from the VA New England MIRECC and the Yale School of Medicine found that 5.6 percent of more than 300,000 Veterans who were referred to anxiety or PTSD clinics experienced homelessness within the one-year time period of the study. The homelessness rate for the entire Veteran population is about 3.7 percent over a five-year period. Veterans who were unmarried or diagnosed with a drug use disorder were more than twice as likely to become homeless.

top

Depression

Depression is one of the most common and costly mental disorders. VA researchers are developing more effective drugs to treat depression by probing the biological roots of the condition. They are also exploring the benefits and risks of a wide variety of existing and potential new treatments.

Additional information on this topic can be found on our Depression topic page.

top

Interrelationship of mental health issues

Communality among psychiatric disorders—A 2015 study by researchers at the VA Palo Alto Healthcare System and Stanford University identified a common pattern across a spectrum of psychiatric disorders widely perceived to be quite distinct.

The research team analyzed 193 peer-reviewed papers that contained magnetic resonance images of the brains of 7,381 patients diagnosed with schizophrenia, bipolar disorder, major depression, addiction, obsessive-compulsive disorder, and a cluster of related anxiety disorder.

They found a loss of gray matter (the darker tissue of the brain and spinal cord, consisting mainly of nerve cell bodies and branching dendrites) in three separate brain structures—the left and right anterior insula and the dorsal anterior cingulate.

These structures are part of a larger network in the brain associated with higher-level executive functions such as concentrating in the face of distractions, multitasking or task switching, planning and decision-making, and inhibition of counterproductive impulses.

Gray matter loss in the three brain structures was similar across patients with different psychiatric conditions, according to the researchers. The findings mirror those from a 2013 study that found shared genetic glitches across several categories of mental illness.

Access to clinicians’ notes can build trust—In 2017, a team of researchers from the VA Portland Health Care System in Oregon looked at the value of giving patients who see mental health care providers access to the notes their clinicians write about their health care visits. They found the Veterans in the study appreciated seeing consistency between what had occurred during their appointments and what they later saw in the clinical notes, and felt respected and reported greater trust when the notes showed evidence that their clinicians had listened to and understood their personal stories and had taken note of their individual strengths. When the Veterans saw diagnoses that hadn’t been discussed with them in the notes, their trust was significantly eroded.

Legal help has mental health benefits—Researchers with the VA New England MIRECC found, in 2017, that 148 Connecticut and New York Veterans who received help from legal non-profit groups embedded with medical teams at VA facilities had reduced levels of hostility, anxiety, and paranoia. The Veterans in the study were clients of two legal assistance groups that worked with medical teams at local VA hospitals and clinics to identify issues that might affect Veterans’ health, such as evictions, disputes with landlords, divorces, or difficulty in obtaining benefits. While some of the mental health benefits were sustained over a year, other benefits, including reduction of symptoms of PTSD or depression did not show sustained improvement.

Precision medicine in mental health care—To achieve a remission from depression, patients and their health care providers must be persistent and try multiple treatments until they find one that is both tolerable and effective. Pharmacogenic testing is a type of genetic testing meant to predict a patient’s likelihood to experience an adverse event from a given drug, or to not respond to that drug. In the last several years, such testing has become widespread for patients with depression as a means of implementing “precision medicine” (the tailoring of medical treatment to the individual characteristics of each patient).

Researchers with VA’s Center for Health Equity Research and Promotion (CHERP) in Philadelphia are looking at the usefulness of pharmacogenic testing in treating major depressive disorder with or without concurrent PTSD. Patients and providers in the study will either be given the results of such testing immediately or after six months of treatment as usual. The study is scheduled to be completed in 2022.

PACT teams for seriously mentally ill Veterans—People with serious mental illness die many years prematurely, with rates of premature mortality two to three times greater than the general public. Research has suggested that integrated care and medical care management can improve health care treatment and outcomes, and reduce treatment costs, in people with serious mental illnesses. VA now uses the Patient Aligned Care Team (PACT) model for primary care, a team-based approach that achieves coordinated care through collaboration among the patient, family members, caregivers, and health care professionals.

Researchers with VA’s Center for the Study of Healthcare Innovation, Implementation, and Policy in Los Angeles are looking at whether a PACT team for Veterans with serious mental illness can improve treatment and outcomes, while reducing unnecessary use of emergency and hospital services. The study began in 2014 and is expected to conclude in 2018.

Maternal psychological disorder effects on children—A 2018 study that included a VA researcher found that prenatal exposure to maternal stress and depression could lead to psychological disorders in children. The researchers found that children born to mothers with PTSD, depression, or both together showed a pattern of gene expression not seen in children of mothers without psychological disorders. These changes in gene expression were similar to genetic biomarkers associated with autism spectrum disorder and schizophrenia. The results suggest that exposure to maternal psychological distress in utero may put children at risk for impaired psychological development.

Mental health and unintended pregnancy—Women Veterans with mental health disorders are more likely to have experienced unintended pregnancy than those without, found a 2018 study by VA Pittsburgh Health Care System researchers and colleagues. They surveyed almost 3,000 women Veterans by phone. Sixty percent of women with at least one mental health disorder reported having an unintended pregnancy, while 51 percent of women without a mental health disorder said they had had an unintended pregnancy. Mental health disorders were also connected to a greater number of unintended pregnancies. More research is need on how to improve reproductive health outcomes for women with mental health disorders, say the researchers.

top

PTSD

In recent years, VA investigators have made important strides in understanding PTSD, an anxiety disorder often linked with combat. PTSD also occurs after other types of trauma including sexual or physical abuse or assault; terrorist attacks; serious accidents, such as car wrecks; and natural disasters, such as fires, tornadoes, hurricanes, floods or earthquakes.

Symptoms of PTSD include reliving the event; avoiding of situations that remind those who have undergone trauma of the event; experiencing negative changes in beliefs and feelings; and feeling keyed up, also called hyperarousal.

Most people have some stress-related reactions after a traumatic event, but not everyone gets PTSD. Those whose reactions don’t go away over time and disrupt their lives may have PTSD.

Additional information on this topic can be found on our PTSD topic page.

top

Schizophrenia and bipolar disorder

According to a 2016 study published in the American Journal of Public Health, over 1.1 million Veterans who were treated in a VA Patient Aligned Care Team (PACT) between 2010–2011 were diagnosed with at least one of five mental illnesses—depression, PTSD, substance use disorder, anxiety, and schizophrenia or bipolar disorder.

Schizophrenia is a chronic and severe psychiatric disorder affecting approximately 120,000 Veterans receiving VA health care, according to a 2014 study. People affected with the disorder may experience hallucinations, delusions, difficulty feeling pleasure, and trouble focusing or paying attention. The symptoms of schizophrenia typically surface between the ages of 16 to 30.

In 1997, a VA research team found that the difficulty many people with schizophrenia have in sorting out sounds, leading them to hear voices, has to…


VA research on

Mental Health

Introduction

Mental health conditions are common in the United States. According to the National Institute of Mental Health, nearly one in five U.S. adults live with a mental illness (46.6 million in 2017). More than 1.7 million Veterans received treatment in a VA mental health specialty program in fiscal year 2018.

VA offers a wide range of mental health services to Veterans. The goal of VA mental health care is to support recovery and enable Veterans who experience mental health problems to live meaningful lives in their communities and achieve their full potential.

The department aims to provide coordinated care for the whole person, not just for the person’s mental illness. VA promotes the idea that having a healthy body, satisfying work, and supportive family and friends are integral to mental health. All Veterans who receive specialty mental health care have mental health treatment coordinators to help them define and work toward their overall mental health goals.

Mental health services are available in VA’s mental health specialty clinics, primary care clinics, nursing homes, and residential care facilities. At most of VA’s larger primary care venues, VA now integrates mental health staff into Patient Aligned Care Teams (PACTs), allowing those care teams to provide services for depression, anxiety, posttraumatic stress disorder (PTSD), and substance use without needing a separate consult with mental health providers outside of the PACT clinic area. Those with serious mental health problems may take part in specialized programs such as mental health intensive case management, day centers, work programs, and psychosocial rehabilitation.

Emergency mental health care is available 24 hours a day, seven days a week at VA medical centers. Facilities that do not have 24-hour emergency rooms must provide emergency services through a local non-VA hospital.

Veterans thinking about hurting or killing themselves or others, experiencing an emotional crisis, feeling hopeless, or engaging in self-destructive behavior such as drug abuse should call the Veterans Crisis Line at 1-800-273-TALK (8255). Press 1 for Veterans.

top

Selected Major Accomplishments in VA Research

  • 1941: Set up a research lab at the Northport VA Medical Center, to conduct clinical and biomedical research in neuropsychiatric disorders
  • 1989: Created the National Center for PTSD to address the needs of Veterans and other trauma survivors with PTSD
  • 1997: Identified a gene associated with a major risk for schizophrenia
  • 2003: Determined that while atypical antipsychotic drugs vary in cost, there is limited evidence of differences in effectiveness
  • 2006: Developed, through VA’s TIDES project, an evidence-based collaborative approach to depression management
  • 2013:
  • Determined an association between homelessness among Veterans and childhood problems such as abuse and family instability
  • Found that a loss of gray matter in three separate brain structures is common across a spectrum of psychiatric disorders widely perceived to be distinct
  • 2016: Found that the use of an injectable antipsychotic led to significant cost-savings related to inpatient admissions of patients with schizophrenia compared to oral atypical antipsychotics
  • 2017: Learned that compensatory cognitive training (CCT) can improve thinking ability, psychiatric symptoms, and quality of life in people with severe mental illnesses

top

New, Ongoing, and Published Research

VA researchers are looking at potential new approaches for treating and preventing mental health disorders. They are also working on related projects such as developing and evaluating collaborative primary care models and improving access to services from rural and other remote areas by using the internet and other technologies.

Among the areas VA researchers are focusing on are mood disorders, such as depression and bipolar disorder; psychotic disorders, such as schizophrenia; PTSD and other anxiety conditions; and substance use disorders. VA investigators are highly organized in identifying, testing, and confirming new treatments for PTSD, especially focused on medications through the PTSD Psychopharmacology Initiative.

VA investigators are also looking at the co-occurrence of mental health issues and physical disorders—for instance, depression in those with spinal cord injury, or substance use disorder in patients with chronic pain.

The National Research Action Plan is a wide-reaching plan developed in 2013 by VA and the departments of Defense, Health and Human Services, and Education. The plan is designed to improve access to mental health services for Veterans, service members, and military families.

Implementation of the plan will improve scientific understanding of PTSD, traumatic brain injury (TBI), various co-occurring conditions, and suicide. Other goals of the plan include providing effective treatments for these diseases and reducing their occurrence.

VA’s 15 Mental Illness Research, Education and Clinical Centers (MIRECCs) research the causes and treatments of mental disorders and use education to put new knowledge into routine clinical practice in VA. Specialized mental health centers of excellence are an essential part of VA’s ability to meet Veterans’ mental health needs.

VA’s Center for Integrated Health Care, located in Canandaigua, New York, is dedicated to advancing research, education, and clinical consultation to enhance the integration of mental health and primary care services for Veterans. The Center of Excellence for Suicide Prevention, also located in Canandaigua, integrates surveillance with intervention development to inform the implementation of effective suicide prevention strategies for Veterans.

The Center of Excellence for Research on Returning War Veterans in Waco, Texas, supports state-of-the-art research on the effects of combat exposure on mental health. Center researchers focus on preventing mental illness in Iraq and Afghanistan Veterans and providing treatment and rehabilitation for those with mental illnesses.

The Center of Excellence for Stress and Mental Health, in San Diego, works to understand the neurobiological mechanisms of responses to trauma and, through this understanding, to develop and disseminate novel, effective treatments.

VA’s National Center for PTSD is a VA group of research centers that focus entirely on the condition.

The department’s Center for Mental Healthcare and Outcomes Research, in North Little Rock, Arkansas, conducts research to improve access to and engagement in evidence-based mental health and substance use care. The Brain Rehabilitation Research Center, in Gainesville, Florida, develops and tests treatments to substantially improve or restore motor, cognitive, and emotional functions that have been impaired by neurologic disease or injury. The Translational Research Center for TBI and Stress Disorders (TRACTS), in Boston, studies the complex changes in the brain, thinking, and psychological well-being that result from traumatic brain injury and PTSD.

Two of VA’s 10 Collaborative Research to Enhance and Advance Transformation and Excellence (CREATE) programs address issues important to mental health. The primary goal of the Evidence-Based Therapies for PTSD CREATE is to improve Veterans’ access to and engagement in evidence-based treatments for PTSD. The Improving Rural Veterans’ Access/Engagement in Evidence-based Mental Healthcare CREATE aims to improve treatment engagement for Veterans living in rural settings who use mental health services at VA community-based outpatient clinics.

VA’s Quality Enhancement Research Initiative (QUERI) for Team-Based Behavioral Health, located in Little Rock, works to improve coordination, quality, equality, and outcomes of team-based care for Veterans with behavioral health conditions. This QUERI team is looking at ways to use measurements in mental health care—for example, having Veterans complete some kind of assessment of their mental health status each and every time they visit a VA mental health practitioner, to provide a score that can be tracked over time. The Virtual Specialty Care QUERI Program is comparing implementation strategies through telemedicine outreach for PTSD to increase Veterans’ access to PTSD services.

top

Anxiety disorders

Anxiety is a normal biological reaction to a stressful event. For some people, however, their anxiety does not go away and may even worsen over time. They can experience symptoms such as nightmares, a racing pulse, and excessive worry or fear. In persistent cases, anxiety disorders such as PTSD, panic disorders, and phobias may develop.

Older Veterans no more likely to have anxiety than non-Veterans—In 2014, a team from the VA Palo Alto Health Care System and Stanford University School of Medicine examined data on 7,000 men age 50 or older, and found that Veterans were no more likely than non-Veterans to have depression or anxiety.

Because Veterans, especially those who served in combat, have generally experienced more stress and trauma in their lives than non-Veterans, the team had expected to see higher rates of depression among Veterans. Instead, they found just the opposite. Older Veterans actually scored better than non-Veterans in the same age group.

The team found 11 percent of Veterans reported elevated rates of depression, compared with 12.8 percent of non-Veterans. For anxiety, 9.9 percent of Veterans reported elevated levels, versus 12.3 percent for non-Veterans. These differences were not considered statistically significant.

Vietnam Veterans, however, were twice as likely to have elevated depression and anxiety, compared with World War II or Korean War Veterans in the study. The team said further studies are needed to explain this finding.

Anxiety sensitivity may link PTSD and suicide risk—Anxiety sensitivity is an exaggerated fear of experiencing symptoms related to anxiety, separate from the actual symptoms. In 2017, researchers at the Southeast Louisiana Veterans Health Care System found a significant association between the severity of PTSD in 60 male Veterans and a greater frequency of suicidal thoughts, plans, and impulses. They also found that cognitive anxiety sensitivity concerns may be responsible for this link—meaning that when people with PTSD worry that their personalities have changed or that they are not thinking normally, they may be at increased risk of suicidal behavior.

Relationship of PTSD and anxiety disorders to homelessness—Researchers from the VA New England MIRECC and the Yale School of Medicine found that 5.6 percent of more than 300,000 Veterans who were referred to anxiety or PTSD clinics experienced homelessness within the one-year time period of the study. The homelessness rate for the entire Veteran population is about 3.7 percent over a five-year period. Veterans who were unmarried or diagnosed with a drug use disorder were more than twice as likely to become homeless.

top

Depression

Depression is one of the most common and costly mental disorders. VA researchers are developing more effective drugs to treat depression by probing the biological roots of the condition. They are also exploring the benefits and risks of a wide variety of existing and potential new treatments.

Additional information on this topic can be found on our Depression topic page.

top

Interrelationship of mental health issues

Communality among psychiatric disorders—A 2015 study by researchers at the VA Palo Alto Healthcare System and Stanford University identified a common pattern across a spectrum of psychiatric disorders widely perceived to be quite distinct.

The research team analyzed 193 peer-reviewed papers that contained magnetic resonance images of the brains of 7,381 patients diagnosed with schizophrenia, bipolar disorder, major depression, addiction, obsessive-compulsive disorder, and a cluster of related anxiety disorder.

They found a loss of gray matter (the darker tissue of the brain and spinal cord, consisting mainly of nerve cell bodies and branching dendrites) in three separate brain structures—the left and right anterior insula and the dorsal anterior cingulate.

These structures are part of a larger network in the brain associated with higher-level executive functions such as concentrating in the face of distractions, multitasking or task switching, planning and decision-making, and inhibition of counterproductive impulses.

Gray matter loss in the three brain structures was similar across patients with different psychiatric conditions, according to the researchers. The findings mirror those from a 2013 study that found shared genetic glitches across several categories of mental illness.

Access to clinicians’ notes can build trust—In 2017, a team of researchers from the VA Portland Health Care System in Oregon looked at the value of giving patients who see mental health care providers access to the notes their clinicians write about their health care visits. They found the Veterans in the study appreciated seeing consistency between what had occurred during their appointments and what they later saw in the clinical notes, and felt respected and reported greater trust when the notes showed evidence that their clinicians had listened to and understood their personal stories and had taken note of their individual strengths. When the Veterans saw diagnoses that hadn’t been discussed with them in the notes, their trust was significantly eroded.

Legal help has mental health benefits—Researchers with the VA New England MIRECC found, in 2017, that 148 Connecticut and New York Veterans who received help from legal non-profit groups embedded with medical teams at VA facilities had reduced levels of hostility, anxiety, and paranoia. The Veterans in the study were clients of two legal assistance groups that worked with medical teams at local VA hospitals and clinics to identify issues that might affect Veterans’ health, such as evictions, disputes with landlords, divorces, or difficulty in obtaining benefits. While some of the mental health benefits were sustained over a year, other benefits, including reduction of symptoms of PTSD or depression did not show sustained improvement.

Precision medicine in mental health care—To achieve a remission from depression, patients and their health care providers must be persistent and try multiple treatments until they find one that is both tolerable and effective. Pharmacogenic testing is a type of genetic testing meant to predict a patient’s likelihood to experience an adverse event from a given drug, or to not respond to that drug. In the last several years, such testing has become widespread for patients with depression as a means of implementing “precision medicine” (the tailoring of medical treatment to the individual characteristics of each patient).

Researchers with VA’s Center for Health Equity Research and Promotion (CHERP) in Philadelphia are looking at the usefulness of pharmacogenic testing in treating major depressive disorder with or without concurrent PTSD. Patients and providers in the study will either be given the results of such testing immediately or after six months of treatment as usual. The study is scheduled to be completed in 2022.

PACT teams for seriously mentally ill Veterans—People with serious mental illness die many years prematurely, with rates of premature mortality two to three times greater than the general public. Research has suggested that integrated care and medical care management can improve health care treatment and outcomes, and reduce treatment costs, in people with serious mental illnesses. VA now uses the Patient Aligned Care Team (PACT) model for primary care, a team-based approach that achieves coordinated care through collaboration among the patient, family members, caregivers, and health care professionals.

Researchers with VA’s Center for the Study of Healthcare Innovation, Implementation, and Policy in Los Angeles are looking at whether a PACT team for Veterans with serious mental illness can improve treatment and outcomes, while reducing unnecessary use of emergency and hospital services. The study began in 2014 and is expected to conclude in 2018.

Maternal psychological disorder effects on children—A 2018 study that included a VA researcher found that prenatal exposure to maternal stress and depression could lead to psychological disorders in children. The researchers found that children born to mothers with PTSD, depression, or both together showed a pattern of gene expression not seen in children of mothers without psychological disorders. These changes in gene expression were similar to genetic biomarkers associated with autism spectrum disorder and schizophrenia. The results suggest that exposure to maternal psychological distress in utero may put children at risk for impaired psychological development.

Mental health and unintended pregnancy—Women Veterans with mental health disorders are more likely to have experienced unintended pregnancy than those without, found a 2018 study by VA Pittsburgh Health Care System researchers and colleagues. They surveyed almost 3,000 women Veterans by phone. Sixty percent of women with at least one mental health disorder reported having an unintended pregnancy, while 51 percent of women without a mental health disorder said they had had an unintended pregnancy. Mental health disorders were also connected to a greater number of unintended pregnancies. More research is need on how to improve reproductive health outcomes for women with mental health disorders, say the researchers.

top

PTSD

In recent years, VA investigators have made important strides in understanding PTSD, an anxiety disorder often linked with combat. PTSD also occurs after other types of trauma including sexual or physical abuse or assault; terrorist attacks; serious accidents, such as car wrecks; and natural disasters, such as fires, tornadoes, hurricanes, floods or earthquakes.

Symptoms of PTSD include reliving the event; avoiding of situations that remind those who have undergone trauma of the event; experiencing negative changes in beliefs and feelings; and feeling keyed up, also called hyperarousal.

Most people have some stress-related reactions after a traumatic event, but not everyone gets PTSD. Those whose reactions don’t go away over time and disrupt their lives may have PTSD.

Additional information on this topic can be found on our PTSD topic page.

top

Schizophrenia and bipolar disorder

According to a 2016 study published in the American Journal of Public Health, over 1.1 million Veterans who were treated in a VA Patient Aligned Care Team (PACT) between 2010–2011 were diagnosed with at least one of five mental illnesses—depression, PTSD, substance use disorder, anxiety, and schizophrenia or bipolar disorder.

Schizophrenia is a chronic and severe psychiatric disorder affecting approximately 120,000 Veterans receiving VA health care, according to a 2014 study. People affected with the disorder may experience hallucinations, delusions, difficulty feeling pleasure, and trouble focusing or paying attention. The symptoms of schizophrenia typically surface between the ages of 16 to 30.

In 1997, a VA research team found that the difficulty many people with schizophrenia have in sorting out sounds, leading them to hear voices, has to…

(Visited 3 times, 1 visits today)
Previous Post
Psychologist Job Duties, Job Description and Employment Opportunities
Next Post
Psychology careers guide
Jess Olague

Let me help you build your own website, or create whatever you need. PM me for quotes.

0 Comments

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: