TY - JOUR
KW - access to care
KW - Engagement in treatment
KW - integrated care
KW - Mental healthcare
KW - Rehabilitation program
AU - M. R. Baig
AU - R. N. Tapia
AU - A. Meraj
AU - J. A. Pugh
AU - J. D. Roache
AU - E. P. Finley
A1 - 
AB - (i) To describe an integrated model of psychiatric care for the treatment of posttraumatic stress disorder (PTSD) in veterans with mild traumatic brain injury (mTBI). (ii) To evaluate access to and engagement in psychiatric care among veterans with comorbid PTSD and mTBI after implementation of an Integrated Care (IC) model compared to the previous Usual Care (UC). 100 randomly selected charts, 50 from each of UC and IC were reviewed in this non-concurrent case- control study. Polytrauma Network Site (PNS), an outpatient rehabilitation clinic, for veterans who suffered from brain and other traumatic injuries at an urban VA Polytrauma Rehabilitation Center. Veterans receiving treatment for mTBI symptoms by the rehabilitation team were referred for medication management for PTSD to UC and IC. Co-located access to psychiatric care for medication management as part of the interdisciplinary team with the goal of expediting rehabilitation and functional recovery. Number of consults for psychiatric care for medication management scheduled and completed within 30 days, and number of veterans offered, initiating, and completing evidence-based psychotherapies for PTSD in UC compared to IC. After implementation of IC there were significant improvements in timely completion of consults and patient engagement with a psychiatrist. There also were improvements in number of referrals, initiation, and completion of evidence-based psychotherapies for the treatment of PTSD. IC within the PNS shows promise as an effective care model for increasing access and engagement in care for veterans with comorbid PTSD/mTBI. Future research is needed to examine the utility of this model in other sites.
AD - Mental Health, South Texas Veterans Healthcare System, Mail Code A116, 7400 Merton Minter Blvd., San Antonio, TX, 78229, USA. muhammad.baig@va.gov.; Polytrauma Rehabilitation Center, Mail Code A116, 7400 Merton Minter Blvd., San Antonio, TX, 78229, USA. muhammad.baig@va.gov.; Department of Psychiatry, University of Texas Health Science Center at San Antonio, Mail Code A116, 7400 Merton Minter Blvd., San Antonio, TX, 78229, USA. muhammad.baig@va.gov.; Polytrauma Rehabilitation Center, Mail Code A116, 7400 Merton Minter Blvd., San Antonio, TX, 78229, USA.; Mental Health, South Texas Veterans Healthcare System, Mail Code A116, 7400 Merton Minter Blvd., San Antonio, TX, 78229, USA.; South Texas Veterans Health Care System, San Antonio, TX, USA.; Division of General/Hospital Medicine, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.; Department of Psychiatry, University of Texas Health Science Center at San Antonio, Mail Code A116, 7400 Merton Minter Blvd., San Antonio, TX, 78229, USA.; Department of Psychiatry, University of Texas Health Science Center at San Antonio, Mail Code A116, 7400 Merton Minter Blvd., San Antonio, TX, 78229, USA.; South Texas Veterans Health Care System, San Antonio, TX, USA.; Division of General/Hospital Medicine, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
BT - The Psychiatric quarterly
C5 - Education & Workforce; Healthcare Disparities
CP - 4
CY - United States
DO - 10.1007/s11126-019-09668-7
IS - 4
JF - The Psychiatric quarterly
LA - eng
M1 - Journal Article
N2 - (i) To describe an integrated model of psychiatric care for the treatment of posttraumatic stress disorder (PTSD) in veterans with mild traumatic brain injury (mTBI). (ii) To evaluate access to and engagement in psychiatric care among veterans with comorbid PTSD and mTBI after implementation of an Integrated Care (IC) model compared to the previous Usual Care (UC). 100 randomly selected charts, 50 from each of UC and IC were reviewed in this non-concurrent case- control study. Polytrauma Network Site (PNS), an outpatient rehabilitation clinic, for veterans who suffered from brain and other traumatic injuries at an urban VA Polytrauma Rehabilitation Center. Veterans receiving treatment for mTBI symptoms by the rehabilitation team were referred for medication management for PTSD to UC and IC. Co-located access to psychiatric care for medication management as part of the interdisciplinary team with the goal of expediting rehabilitation and functional recovery. Number of consults for psychiatric care for medication management scheduled and completed within 30 days, and number of veterans offered, initiating, and completing evidence-based psychotherapies for PTSD in UC compared to IC. After implementation of IC there were significant improvements in timely completion of consults and patient engagement with a psychiatrist. There also were improvements in number of referrals, initiation, and completion of evidence-based psychotherapies for the treatment of PTSD. IC within the PNS shows promise as an effective care model for increasing access and engagement in care for veterans with comorbid PTSD/mTBI. Future research is needed to examine the utility of this model in other sites.
PP - United States
PY - 2019
SN - 1573-6709; 0033-2720
SP - 815
EP - 827
EP - 
T1 - Enhancing Access to Psychiatric Care for Posttraumatic Stress Disorder in Veterans with Mild Traumatic Brain Injury through Integrated Services
T2 - The Psychiatric quarterly
TI - Enhancing Access to Psychiatric Care for Posttraumatic Stress Disorder in Veterans with Mild Traumatic Brain Injury through Integrated Services
U1 - Education & Workforce; Healthcare Disparities
U2 - 31446544
U3 - 10.1007/s11126-019-09668-7
VL - 90
VO - 1573-6709; 0033-2720
Y1 - 2019
Y2 - Dec
ER -