Welcome to the Southern Arizona VA Health Care System Tucson AZ

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1 Welcome to the Southern Arizona VA Health Care System Tucson AZ

2 About us 285 bed hospital 7 CBOCs Serves 170,000 Veterans Employs 2500 people In 2015 we treated over 9000 inpatients & completed 680,000 outpatient Visits Training Programs for health care professionals in every discipline

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4 MENTAL HEALTH SERVICES Outpatient Care Primary Care Mental Health Integration General Mental Health Trauma therapies(ptsd,mst, DBT) Family therapy Psychological and Neuropsychological testing Psychiatric and Care Coordination Integrated medical care for Vets with SMI- Agave Clinic Recovery & Rehabilitation Homeless Walk in Clinic Employment programs Housing - HUD VASH HPACT- Health care for Homeless Veterans Veterans Justice Outreach MHICM intensive case management for Veterans with Serious Mental Illness PRRC (Psychosocial Recovery and Rehabilitation program) Substance Abuse disorders Clinic

5 In Patient Programs Acute Inpatient and Detoxification 26 acute care beds Psychiatric Inpatient Collaboration with DOD 5 beds in patient psychiatric beds available to active duty members from surrounding bases

6 Joint Incentive Fund Project (JIF) Psychiatric Inpatient Collaboration with DOD 5 beds in patient psychiatric beds available to active duty members from surrounding bases Davis-Monthan Ft Huachuca

7 Mental Health Residential Rehabilitation and Treatment Program Building 95 MH RRTP PTSD 7 beds for Male or Female Veterans 7 week Cohort model Group and Individual therapy 6 hours/day Prolonged Exposure & Cognitive Processing therapy models used in addition to many other modalities Substance Abuse /Co-Occuring disorders Residential Program 18 beds- Male and Female Veterans 30 day Cohort model 6 hours/day treatment services Veterans with dual diagnosis accepted

8 New and exciting at SAVAHCS Distress Tolerance Group Weekly drop in group that can be accessed in Building 80 (primary care clinic) Utilizing the DBT Distress Tolerance Skills the group teaches coping skills for tolerating painful events, urges and emotions that cannot be changed right away Mindfulness exercises are also practiced Group run by PSS and 2 LMSW staff. Anyone can attend- no referral needed.

9 New and exciting at SAVAHCS Mental Health Recovery Group 4 week group for patients recently discharged from the inpatient psychiatry unit Incorporates CBT and the Wellness Self- Management workbook to help patients identify positive versus negative thinking patterns, goal setting, understanding stress/triggers and the importance of living a healthy lifestyle One Distress Tolerance skill is covered weekly in order to increase the patient s coping skill toolbox Group helps bridge material that is discussed while on the inpatient unit

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11 Southern Arizona Fisher House

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14 Transgender Care at SAVAHCS Face-to-face transgender clinic (with shared medical appointment, psychology, social work, medicine, and pharmacy services) on one afternoon a month Weekly transgender support group, located in the Women s Health clinic Mental Health Clearance evaluation for gender re-assignment surgery All required letters for gender transition are generated from this team. Trans-Positive mental health treatment We also have several providers in the community, as well as elsewhere in the US that offer surgery through Medicare.

15 Suicide Prevention 2 FTE SP Coordinator and Clinician Track and monitor Veterans who are identified as high risk Respond to Veterans Crisis line calls Coordinate Veteran care in VA system and in community many Veterans receive care in communities served by SAVAHCS Outreach to community events- most recently SPCs attended events in Yuma, Florence, Sierra Vista and Safford Provide staff education on risk assessment and stratification of risk, consultation to BHIP teams on flagging high risk Veterans and monitoring and removal of flags

16 REACH VET REACH Vet is a new program using statistical modeling to identify the 0.1% of Veterans at higher risk for suicide or other adverse outcomes. Veterans are offered increased access to care as well as enhancement in care based on recent psychiatric admissions or certain combinations of medications or frequent visits to ED or chronic pain or medical issues. We have identified Veterans in this category and have had successful outreach to over 60% of them by their primary psychiatric provider with offers of enhanced care or sooner follow up appointments

17 Veterans Crisis Line: 9 years of saving lives 13

18 Thank you for your service

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20 Questions? Bonner Raskob LCSW Local Recovery Coordinator Reach Vet Coordinator Contact information: Southern Arizona VA Health Care System x 1375 bonner.raskob@va.gov

21 Mental Health Phone Applications

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23 Dream EZ Dream EZ is a smartphone app designed to help a person rewrite their nightmares to make them diminish in intensity and frequency. The app uses principles from Imagery Rehearsal Therapy (IRT) for nightmare reduction to help users change their nightmares into less disturbing dreams so they can get a better night s sleep. Although Dream EZ can be used on its own, this app was designed to be used along with a health care provider trained in IRT. Imagery Rehearsal Therapy (IRT) is a proven non-medication treatment that helps a user reimagine the script of their nightmare to rewrite it to have a more pleasant outcome. Similar to how an athlete can visualize a high level of performance in an upcoming game, the brain s imagery system can be retrained over time to change the storyline of a nightmare. By engaging in dream re-scription and imagery rehearsal, the dream content becomes less disturbing and less likely to cause a person to wake up from a nightmare. People that use IRT typically do not report that they have the actual re-visualized dream; instead, they report either that their nightmares happen less frequently, do not happen at all, or tend to be less disturbing, which makes it easier to return to sleep. Get Dream EZ from the itunes Store: Dream EZ for ios(link is external) Get Dream EZ from Google Play: Dream EZ for Android(link is external)

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