Mental health in the department of defense from policy to programs and patients
This presentation is the property of its rightful owner.
Sponsored Links
1 / 29

Mental Health in the Department of Defense: From Policy to Programs and Patients PowerPoint PPT Presentation


  • 78 Views
  • Uploaded on
  • Presentation posted in: General

Mental Health in the Department of Defense: From Policy to Programs and Patients. CAPT Robert DeMartino CDR Meena Vythilingam CDR Robert Marietta CAPT Paul Andreason.

Download Presentation

Mental Health in the Department of Defense: From Policy to Programs and Patients

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Mental health in the department of defense from policy to programs and patients

Mental Health in the Department of Defense: From Policy to Programs and Patients

CAPT Robert DeMartino

CDR Meena Vythilingam

CDR Robert Marietta

CAPT Paul Andreason


Mental health in the department of defense from policy to programs and patients

Challenges and Opportunities for PHS Officers at the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury(DCoE)

CDR Meena Vythilingam

Director, PH CSoC

June 2012


Mental health in the department of defense from policy to programs and patients

Who We Are

Mission, Vision and Values

Organization

What We Do

Functions

Programs

Products

Opportunities

Contact Information

Overview


Mental health in the department of defense from policy to programs and patients

DCoE - Who Are We?

  • Mission

  • Improve the lives of our nation’s service members, families and veterans by advancing excellence in psychological health and traumatic brain injury prevention and care.

  • Vision

  • To be the Defense Department’s trusted source and advocate for psychological health and traumatic brain injury knowledge and standards, and profoundly improve the system of care.

  • Values

  • Excellence

  • Integrity

  • Teamwork


Mental health in the department of defense from policy to programs and patients

DCoE* Governance & Authority

Secretary of Defense

Mr. Leon Panetta

Dep. Secretary of Defense

Mr. Ashton Carter

Undersecretary of Defense

Personnel & Readiness

Dr. Jo Ann Rooney (acting)

Dr. Jonathan Woodson

Assistant Secretary

of Defense - HA

Capt. Paul Hammer

Director, Defense Centers

of Excellence PH/TBI

DD- PH

DD- TBI

Col Robinson

Ms. Helmick

Dr. Mark Bates

TBI-CSoC

Ms. Kathy Helmick

R&P

PH-CSOC

CDR Meena Vythilingam

Education

Mr. Carlton Drew

* Undergoing organizational restructuring and will be transitioning to MRMC


Mental health in the department of defense from policy to programs and patients

PH Clinical Standards of Care

320/07

GS-13

320/06

GS-14

320/05

O-4

320/04

GS-13

310/05

GS-11

Health Analyst

320/03

E-7

310/04

GS-13

310/07

GS-13

310/03

GS-13

Psych. Consult. Lead

320/02

O-4

Clinical Psychologist

310/06

GS-14

310/02

GS-14

Nurse Case Manager

Sr. Enlist. MH Advisor

Clinical Support Tools

Health Analyst

Clinical Guide. Coord.

Healthcare Admin Cons.

Psychologist (SME)

Psychiatrist (SME)

Social Science Analyst

GS-13

300A/04

GS-14

300A/03

RES. ASST PROG ANAL.

Senior advisor ph

CDR Vythilingam (USPHS)

Director

Program Effectiveness

Clinical Guidelines

Dr. Kathy McGraw

Deputy Director

- Division Chief-

Program Effectiveness

- Division Chief-

Clinical Guidelines

320/01

GS-14

310/01

GS-14

Psychiatrist Consultant


Mental health in the department of defense from policy to programs and patients

What We Do

  • Serve as the principal integrator and authority on psychological health and TBI knowledge and standards for the Defense Department

  • Uniquely positioned to accelerate improvements in psychological health and TBI outcomes and policy to impact the continuum of care across the services

Continuum of Care

Treatment

AcuteRecovery

Diagnosis

Reintegration

Surveillance

Rehabilitation

Prevention

Screening

Resilience


Mental health in the department of defense from policy to programs and patients

DCoE: PH/TBI Integrator in the System of Care


Mental health in the department of defense from policy to programs and patients

CLINICAL GUIDELINES DIVISION

Mission: To develop and provide evidence based PH clinical guidelines to the Military Health System.

Functions:Identify, develop, monitor, and revise psychological health Clinical Practice Guidelines (CPGs), Clinical Support Tools (CSTs), and other forms of evidence based guidance designed to assist clinicians in delivering quality care to patients.


Mental health in the department of defense from policy to programs and patients

The VA/DoD CPGs were developed in an effort to standardize the management of PTS and MDD. Some of the same topics are emphasized for both disorders

  • Patient centered care

  • Emphasis on screening

  • Emphasis on early identification and intervention

  • Functional assessment

  • Evidence-based pharmacology recommendations

  • Providers trained in evidence-based treatment provide care

  • Patient and family education

VA/DoD CPGs are available at:

www.qmo.amedd.army.mil/pguide.htm

www.healthquality.va.gov/

www.dcoe.health.mil


Mental health in the department of defense from policy to programs and patients

A “Toolkit” is comprised of a group of related CSTs. Evidence-based recommendations from the CPGs provide the foundation for the content of these tools


Mental health in the department of defense from policy to programs and patients

A stepped care treatment plan includes a recommended timeline for psychotherapy and pharmacotherapy interventions


Ptsd care pathway model

PTSD Care Pathway Model

Care Pathway for PTSD

Acute Stabilization

(Hosp or Amb)

Initial Treatment (Recovery)

Pre-Treatment

Rehabilitation

Post Acute

Prevention

Maintenance

EXAMPLES OF METRICS/MEASURES:

Outcome Measures (Porter’s Model)

One Year Mortality Rate

Suicide Rate

Expanded Porter’s Model on Next Slide

Process / alerts

Time from Positive Screen to Treatment

Follow-Up With in 4-6 Weeks

Cost

Inpatient Hospitalization Costs

Prescription Medication Costs

Patient satisfaction/trust /activation

Patient Satisfaction

Patient Activation Measure

Patient data captured regularly by clinician

Electronic medical records data

Structured documentation


Mental health in the department of defense from policy to programs and patients

Program Evaluation Division

Evaluate Individuals Programs

DoD Wide Program Effectiveness

  • National Guard Bureau

  • OSD CAPE

  • DoD Dashboard

Evaluate Efficacy of CPG and CST

DoD Program Review

  • RAND: identify, catalogue, assess, evaluate and improe the cost effectiveness of all DoD PH programs

  • Evaluation of tools (e.g. CST, CPG and CR)

  • Outcomes Assessments related to tools (e.g. CST, CPG and CR)


Mental health in the department of defense from policy to programs and patients

Collaboration with the VA- IMHS


Mental health in the department of defense from policy to programs and patients

Challenges and Opportunities

at DCoE

Meena Vythilingam, M.D.

CDR, USPHS

Director

Psychological Health Clinical Standards of Care

Defense Centers of Excellence (DCoE)

W: 301-295-2615

[email protected]


Dod and phs mental health partnership experiences at langley air force base

DoD and PHS Mental Health PartnershipExperiences at Langley Air Force Base

COA Annual Meeting

June 22, 2012

Bob Marietta, MD

CDR, US Public Health Service


Mental health in the department of defense from policy to programs and patients

  • Our Mission:

  • Train, Organize, Equip, & Deploy Expeditionary Medics

  • Provide World Class Healthcare for our Beneficiaries -- Anytime; Anywhere!

  • Our Vision:

  • Be the Clinical & Expeditionary Center of Healthcare Excellence

  • 633 MDG is a Currency & Operational Platform for our Nation


Mental health in the department of defense from policy to programs and patients

7 Currency Hospitals in the AFMS 2011

Where the Staff is:

Travis AFB

Wright-Patterson AFB

Nellis AFB

Langley AFB

Elmendorf AFB

Eglin AFB

Keesler AFB

Opportunity to recapture business:

Langley: Largest Opportunity—Smallest Footprint


Who are we

Who Are We?

  • Largest Beneficiary Population in AF

    • An Even Bigger Multi-Service Market

  • Largest Growth in Past 3 Years

  • Busiest in AF for OB

  • 1st C-CMRF mission in DoD & Pilot unit for GRF/HRT

  • 26,000 Outpatient visits/month

  • 83,000 Prescriptions per month

  • 12,000 Dental & Dental Lab Procedures/month

  • Surgery - 250 OR cases/month

  • LDRP– 100 births/month

  • 3,100 X-Rays/month

1 of 7 Specialty Hospitals in the AFMS


Multiple capability hospital

Multiple Capability Hospital

Primary Care Medicine

  • Family Medicine Pediatrics

  • Internal MedicineFlight Medicine

    Specialty Services

  • Emergency ServicesGeneral Surgery

  • OrthopedicsOB/GYN

  • OphthalmologyOptometry/Audiology

  • UrologyMental Health

  • Otolaryngology (ENT) Physical Therapy

  • Dermatology Chiropractics (AD only)

  • Oral Maxillofacial SurgeryPodiatry

    New Services Planned (2011-2012)

  • Pulmonology Gastroenterology

  • NeurologyCardiology

  • AllergyPathology

  • Speech PathologyPeds Surgery

  • Colorectal SurgeryMRI/Nuclear Med


Mental health in the department of defense from policy to programs and patients

Tidewater Overlapping Catchment Areas

Huge Population—Huge Opportunities

Ft. Eustis

Langley AFB

111,000 Beneficiaries

Naval Medical

Center Portsmouth

Total Tidewater : 417,000 Beneficiaries


Behavioral health flight

Behavioral Health Flight

  • Deep set of comprehensive services

    • Occupational medicine

      • Direct patient care

      • Fitness for duty, disability and forensic evaluations

      • Coordination with military officials

    • 24 hour on-call coverage for ER and hospital

    • Two mental health disaster response teams

    • Integration with Primary Care

      • Behavioral Health Optimization Program

    • Joint Army-Air Force Base Family Advocacy Program


Embedded phs officers

Embedded PHS Officers

  • CDR Bob Marietta, Psychiatrist

    • Mental Health Element Chief

  • CDR Bryan Davidson, Psychologist

    • Director of Psychological Health, Behavioral Health Optimization Program

  • LCDR Jenny McCorkle, Clinical Social Worker

    • Family Advocacy Element Chief


Benefit to air force

Benefit to Air Force

  • Much needed, valued services

    • “Breathing room”

      • Reduces workload for critically manned AF personnel

    • Flexible support with local control

      • Custom tailor support to provide best fit

    • Stability

      • Longer tour length

      • Shorter deployments

      • Highly motivated

    • Experience

      • PHS providers further along in career

      • Diverse background


Benefit to phs

Benefit to PHS

  • High profile, visibility

    • Increased attention to mental health services

  • Provide a much appreciated service

  • Work in a uniformed service environment

    • Daily uniform wear

    • Deployment is part of the culture

  • Participation in disaster response teams

    • Good training for PHS mission

  • Skills learned carry over to PHS


Discussion points

Discussion Points

  • Learning curve for Air Force policies and procedures

  • “Purple suit”

    • Ex-Navy goes Air Force

  • Leadership roles

    • Integral part of Air Force officer promotion pathway

  • Acceptance from Air Force officials, colleagues

    • Ex-Air Force provider transfers in to PHS

  • Uniform

    • Good to stand out, easily identifiable

    • BDUs retired by Air Force

  • PHS headquarters support functions


Results

Results

  • Integral part of hospital and Air Force Medical System

    • Trust, appreciation and acceptance

    • Air Force planning personnel movements around PHS personnel


Questions

Questions?

Building The Next Generation in Healthcare


  • Login