Lieutenant Colonel (U.S. Army Retired) Bob Strange Project Director, ASPIN/Indiana Veterans Behavioral Health Network

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Lieutenant Colonel (U.S. Army Retired) Bob Strange Project Director, ASPIN/Indiana Veterans Behavioral Health Network Indiana Council of Community Mental Health Centers, May 10, 2012

Affiliated Service Providers of Indiana, Inc. ASPIN is a 501(C) 3 not for profit network that operates five major service lines: third party contract administration professional training grants management consumer education and workforce development technical assistance

Indiana Veterans Behavioral Health Network Formed by ASPIN in 2009 Awarded a HRSA grant The mission is to increase accessibility of rural veterans to services To create a matrix of family care that meets the needs of rural veterans

Veteran National Statistics 1.6 million veterans deployed to Afghanistan and Iraq for approximately 2.2 times 60 million family members impacted; one third under the age of eighteen 50% of returning reserve/national guard, 40% of regular military, 31% marines suffer from diagnosable mental health conditions; 17-20% meet the diagnostic criteria for Post Traumatic Stress Disorder (PTSD) Source: American Psychoanalytic Association

Indiana Veteran Statistics Over 500,900 veterans of all wars live in Indiana 20,275 service members currently on active duty are residents of Indiana Of the 21,000 + reserve component service members in Indiana, 14,406 (69%) are members of the Indiana National Guard the nation s fourth largest National Guard component

Indiana Veteran Statistics Of the 32,000 + members of the total reserve component in Indiana who have deployed since 9-11, 17,748 (55%) have come from the Indiana National Guard. The latter numbers reflect that some members of the reserve components have been deployed multiple times.

Issues Facing Returning Veterans Deployments cause higher level of child abuse/neglect in families left at home (42%) and higher divorce rates Untreated PTSD lives on inter-generationally and renders the next generations more vulnerable to subsequent traumatization The signature wounds of the Afghanistan and Iraqi wars are Traumatic Brain Injury (TBI) and PTSD Some soldiers suffer from both conditions Source: American Psychoanalytic Association

Public Health Impact of Returning Veterans There is an enormous and unmet need for comprehensive mental health services in urban and rural areas to returned soldiers and to the extended family members impacted by the stresses of deployments and injuries A public health crisis has been created and will continue for years to come if these mental health services are not provided in turn resulting in higher medical costs, loss of income in the work place, dissolution of the family unit, and higher risk of child abuse and child neglect Source: American Psychoanalytic Association

Where Veterans Access Health Services Once they get out of the military only half will receive care from the VA or the military health system There will be a huge number of people appearing elsewhere in the civilian medical system Civilian clinicians should be attuned to asking about patients military experience

IVBHN Goals To connect five selected community mental health centers as access sites to the Indianapolis VA Medical Center tele-behavioral health hub To develop veteran cultural competence among providers of care

Roudebush VA Medical Center & IVBHN Rural Access Sites Roudebush VA Medical Center - Indianapolis Four County Counseling Center Logansport Bowen Center - Warsaw Centerstone of Indiana - Rushville Hamilton Center, Inc. - Bloomfield Wabash Valley Alliance - Crawfordsville

Indiana Veterans Behavioral Health Network

Military Ready Designation Program Designed to establish a network of veteran friendly behavioral health providers throughout Indiana Four levels of designation, depicted in stars

One Star Army OneSource/Military OneSource listing Written guidelines for expedited access for veterans in crisis or with suicidal ideation Intake includes inquiry regarding veteran status and/or connection to military Veteran links on website Resource info for veterans Contact with Family Assistance Centers and local VSOs System for updating staff on clinical issues and resources Track # of veteran and family no show appts/admissions Submits Provider Data Form to IVBHN (annually)

Two Star Initiates process to be an approved TRICARE Provider Knowledge of VA & Veterans services for referral Designates a coordinator for veteran/veteran family collateral services Participates in at least one community event that is specific to veterans Established contact with local/state organizations which service veterans At least one clinician and member of management for each site trained on veteran issues All One Star criteria have been met

Three Star Coordination with VA provider where appropriate Orientation to VA clinical services and referral mechanisms Documentation of TRICARE status Roster/location and contact information for the veteran lead established at all sites of service Performs educational outreach on veteran issues Hosts veteran and family support/education groups Clinicians trained on behavioral health topics relating to veterans and families All one star and two star criteria have been met

Four Star Tele-health equipment that can connect to VA or a VA CBOC with training on relevant protocol -OR- Referral agreement with the VA Medical Centers Veteran representative on board of directors or relevant committees Participation in National Veteran Advocacy Utilization of Veteran peers Clinician(s) have been trained on evidenced based interventions regarding PTSD and other emerging issues All one, two and three star criteria have been met

Designation Process Application Submission & Review Designation is for three years Annual Reporting to IVBHN Conformance Form Self-Audit Tool Provider Data Form

Ultimately Continue to build IVBHN partnerships Designate all Mental Health Centers in Indiana as military friendly Build a database of military friendly providers in the state

Questions? Visit our website www.ivbhn.org Visit our Facebook Page (be sure to like us) Direct Contact information: Deirdre George Davis (ddavis@aspin.org) (317) 721-0011 Bob Strange (bstrange@aspin.org) (317) 536-1566