The Medical Interview and Illness Outcomes

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MIRECC Education and the New Promoting EBPs in
Rural and Other Underserved Populations Theme
Michael R. Kauth, PhD Co-Director and Associate
Director for Education, MIRECC Michael E. DeBakey
VA Medical Center, Houston Baylor College of
Medicine MIRECC Retreat, April 17, 2008
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Education Core

• Michael Kauth, PhD (Houston)
• Su Bailey, PhD (Houston)
• Randy Burke, PhD (Jackson)
• Kathy Henderson, MD (Little Rock)
• Lisa Martone, RN, APN (Little Rock)
• Jeffrey Parker, PhD (Jackson)
• Michelle Sherman, PhD (OKC)
• Cayla Teal, PhD (Houston)
• Tom Teasdale, DrPH (OKC)

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Education Core

• Michael Kauth, PhD (Houston)
• Su Bailey, PhD (Houston)
• Randy Burke, PhD (Jackson)
• Kathy Henderson, MD (Little Rock)
• Lisa Martone, RN, APN (Little Rock)
• Jeffrey Parker, PhD (Jackson)
• Michelle Sherman, PhD (OKC)
• Cayla Teal, PhD (Houston)
• Tom Teasdale, DrPH (OKC)
• 1-2 CBOC representatives. Who??

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CBOC Survey

• Need for information about VA community clinics!
• Needs assessment survey of non-contract VISN 16
  CBOCs (Teal) -
• Objective 1 Foster relationship with the CBOCs
  as groundwork for a Practice Network.
• Objective 2 Gain insight into the mental health
  providers at each CBOC, services provided,
  methods of delivery, and access to services.
• Objective 3 Identify served and underserved
  populations, barriers to providing care.
• Objective 4 Identify CBOC needs (clinical,
  educational, communication, administrative, etc.)
  and potential methods for meeting their needs.
• Target date Summer 2008

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Education Goals

• 1. Provide Network-wide educational opportunities
• 2. Develop or import needed educational materials
• 3. Communicate clinical news and research
  findings to stakeholders
• Assist MHPLAC in clinical and training programs
  (be a resource)

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Education Goals Programs

• 1. Provide Network-wide educational opportunities
• Regional / national conferences (e.g., PTSD)
  rare events
• Monthly web-based presentations cancelled
  Fall 2007
• Network training CBT training implementation
  study
• 2. Develop or import needed educational materials
• Clinical Educators grants
• Product depot
• 3. Communicate clinical news and research
  findings to stakeholders
• MIRECC Communiqué
• Assist MHPLAC in clinical and training programs
  (be a resource)
• VISN 16 Recovery Committee

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Communication

• South Central MIRECC Communiqué
• Objective Communicate, publicize, and engage
  frontline line clinicians, administrators,
  investigators in MIRECC activities.
• First published Feb 22, 1999 (Kauth, editor)
• 10 volumes, 133 issues occasional NewsFlash
• Features Clinical news, research news and
  abstracts, interviews with researchers, training
  opportunities, grant opportunities, library tips,
  recovery education, recovering veterans,
  education products, etc
• Monthly to SC MIRECC leadership, investigators,
  support staff trainees VISN 16 leadership,
  VISN 16 medical center directors COSs Academic
  affiliates TRIPS VISN 16 Recovery Committee
  local recovery coordinators local VISN 16
  facility MH mailgroups 10 MIRECCs, 4 COEs, 2
  QUERIs, NCPTSD national MIRECC COE education
  group OMHS (VACO) others

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Communication

• South Central MIRECC Communiqué
• June 2008 issue (Farmer, editor)
• Continue to publicize MIRECC activities and be an
  important source of information about the MIRECC
• Try to engage community based clinics

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Educational Opportunities

• No didactics at present
• No regional / national conferences emphasis on
  training
• Network-wide training CBT training
  implementation study
• Training in brief CBT for depression to 26 mental
  health therapists in 21 clinics.
• 13 clinics are CBOCs
• 9 clinics were not in the PC-MH initiative

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Educational Opportunities

• Objectives of CBT implementation study
• Enhance use of CBT (an EBP) in CBOCs, as well as
  at medical centers
• 2. Test implementation strategy in CBOCs and
  contrast with results in medical centers
• 3. Begin to develop a relationship with CBOCs and
  potential Practice Network

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Educational Opportunities

• Seeking Safety training implementation study
  SUD QUERI (Kosten, Najavits, Kivlahan, Hagedorn)
  MIRECC (Kauth)
• Training in EB psychotherapy for trauma and
  substance abuse to 100 mental health therapists
  in 10 medical centers and many CBOCs.
• 5 trainings at different locations in June -
  July?

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Educational Opportunities

• Future Network-wide trainings
• Marital and family therapy
• Developing family psychoeducation services
• Remote delivery of treatments
• Developing peer support groups
• ???
• Identify needs from CBOC survey
• Identify needs from MHPLAC

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Develop / Import Education Materials

• Clinical Educator Grants
• Objective Engage frontline providers with
  MIRECC and tap into clinical expertise to develop
  exportable education products
• Appx 71 grants at appx 215,409.00
• 30 exportable products one of the SC MIRECCs
  most successful programs!

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Disseminate Products

• 520 requests for products in 2007 1,891 copies
  of products distributed
• Age-Specific Role Competency Curriculum for
  Substance Abuse Treatment Staff
• Anger Management Patient Handbook and
  Instructors Guide 27
• Coping with Chronic Pain DVD
• Day Treatment Center Newsletters Togetherness,
  Acceptance Respect
• Discontinuing Your Medication for Depression
  brochure
• Gambling Education Workbook
• Guidelines for Monitoring Antipsychotic
  Side-Effects pocketguide
• Health Promotion Materials for PTSD Veterans
  video brochure
• Helping Dementia Caregivers CD-ROM
• HIV Medication Adherence Intervention paper
• 
  
  Noted if 10 or requests

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Disseminate Products

• Insomnia Difficulty Falling Asleep or Staying
  Asleep, and Quality of Sleep brochure 23
• Keeping the Mind Body Well video
• Managing Disruptive Behavior in Dementia
  Patients A training tool for clinical nurse
  assistants CD-ROM
• Messing with Your Habit A Tobacco Use Reduction
  Program CD
• Music Therapy Directed Relaxation Training manual
• Playing It Safer Workbook
• PTSD Families Matter DVD 82
• Quitting It All Tobacco Cessation for Chemical
  Dependence and Dual Diagnosis Treatment Programs
• SAFE Program Manual-Revised 10
• Treating Chronic Pain in Substance Abusing
  Patients An Interactive Primer CD
• Us and Them The Experience of Mental Health
  Stigma CD 57
• 
  
  Noted if 10 or requests

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Disseminate Products

• Veterans Helping Veterans Key Insights for PTSD
  Recovery audio CD 52
• The Healing Circle DVD
• Community Reinforcement and Family Training
  Support and Prevention (CRAFT-SP) manual
• Traumatic Brain Injury Brochure Making the
  Invisible Visible 56
• Relaxation Enhancement Therapist manual Stress
  for Less manual for Stress Management Group
  (Franklin) 77
• Resilience to Trauma DVD (2008)
• A Stress Reaction Model From Stress to PTSD
  (Friedman) video 51
• Traumatic Grief Treatment An Overview (Shear)
  video 50
• Treatment of Nightmares and Insomnia Related PTSD
  (Raskind) video 54
• 
  
  Noted if 10 or requests
• Target CBOCs for dissemination of products

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Develop / Import Education Materials

• Clinical Educator Grants
• In past, set some general limits but reviewed
  all submitted proposals funded best.
• In the future, offer service directed grants
• 1) fund projects that support MIRECC theme,
  particularly rural access,
• 2) identify a rural based project and issue
  targeted RFP
• How to encourage applications from CBOCs and not
  to exclude participation from the medical
  centers??

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Assist MHPLAC

• VISN 16 Recovery Committee, co-chairs (Hamilton,
  Kauth)
• Members Bateman (Vet Center), Brister (NAMI),
  Chinman (consultant), Gearin, Hansson (vet),
  Martone, Schmidt (vet)
• 2007 recommendations approved by MHPLAC
• Coordinate recovery activities e.g., PSR group,
  LRCs, recovery DVD development, PRRCs, etc.
• Consumer Councils at all medical centers
• Recovery Plans in MHICMs (piloted first at two
  sites)

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Assist MHPLAC

• VISN 16 Recovery Committee
• As of Feb 2008
• Meet quarterly with recovery focused groups
  LRCs, PRRCs, Consumer Councils, etc.
• 9/10 medical centers have active Consumer
  Councils
• Recovery Plan pilot completed (3 MHICMs and 2
  PRRCs) at Houston and Little Rock
• - 3/08 VISN-wide roll out of Recovery Plans to
  all MHICMs and PRRCs

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Assist MHPLAC

• VISN 16 Recovery committee
• Next steps
• Expand Recovery Plan roll out to other SMI
  programs link Recovery Plans across SMI
  programs. To CBOCs?
• Active Consumer Councils at 10 medical centers
• Promote family psychoeducation and services.
  CBOCs!
• Promote peer support services and peer
  technicians. At CBOCs?

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Summary

• MIRECC Education Core adoption of new MIRECC
  theme
• Add rural expert and CBOC representatives to Ed
  Core
• Participate in CBOC survey development use
  results to plan future education activities with
  CBOCs
• Continue MIRECC Communiqué Farmer as Editor
• Offer service directed Clinical Educator Grants
  that support new theme esp target CBOC
  participation
• Include CBOCs in future network clinical
  trainings
• Expand recovery implementation to CBOCs where
  possible esp family psychoeducation and services