I started the day with one of the psychologists from the PTSD treatment training team at his clinic at the Warrior Transition Unit. I had managed to spend sometime with his team the previous day. They are a small team of psychologists and licensed social workers that deliver PTSD training to other Behavioural Health providers. This includes EMDR, PE and CPT. This means they don’t have to buy in training like we do in the UK and helps ensure the delivery of evidence based treatments for PTSD. However, they did admit because they are so small they have no way to ensure the continuity of high quality treatment or adherence to treatment guidelines once the clinician has completed the course. But that aside, this an approach I believe we should be taking in the UK as they are able to devise training protocols specifically for military PTSD.
I was able to spend time with the social work manager of the Warrior Transition Unit which provides out-patient mental health care to wounded warriors from Brooke Army Medical Centre. Although a clinical service they come under the control of the executive in Fort Sam Houston and that enables them to keep good links with the command on the management of soldiers. They main remit is in risk management but they are also involved in the treatment of personnel and their dependents with mental health problems including PTSD. It seemed to work in the similar way to out DCMHs with a key difference is that their Social Workers carry out the work that our community mental health nurses do. Their psychiatric nurse practitioners seem to be mainly hospital based and heavily involved with the prescription of medication and delivery of medical model based care.
I was then fortunate enough to take a tour of the Centre for the Intrepid which is the US version of our rehabilitation facility at Headley Court. Its creation was fully funded by donations and built in just 16 months. The running of it is now funded by the DoD. Not surprisingly the facilities are state of art. I’ve not visited Headley Court but I don’t expect it has anything like the resources of CFI. These include a $1.5 virtual reality training room that helps train people to use their prosthetic limbs and is able to recreate Iraqi landscapes as well as jet skiing! Their pool includes a wave rider so people can practice surfing whilst working on their core conditioning. It includes a Behavioural Health section but I wasn’t able to speak to them during the visit which was a shame. However, I was told they work closely with the physiotherapists and provide mental health care when and where appropriate. It’s a truly amazing facility.
