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Mental Health – Evidence Based Practices

New Publication
Practice Guidelines: Core Elements in Responding to Mental Health Crises

cmhs_practiceguidelines

Individuals experiencing mental health crises may encounter an array of professionals and nonprofessionals trying to intervene and help: family members, peers, health care personnel, police, advocates, clergy, educators, and others. Their approaches in assisting those in crises often vary widely, contributing to the potential for ineffectual responses.
Developed by a diverse expert panel that included individuals with mental illnesses, providers, public officials, and advocates, the guidelines presented here define appropriate responses to mental health crises across various situations and environments.

For more information click here.

Department of Veterans Affairs:  Post-Traumatic Stress Disorders (PTSD):

http://www.healthquality.va.gov/Post_Traumatic_Stress_Disorder_PTSD.asp

Screening:

Assessment:

Treatment:

Information on PTSD:

Information on Military Sexual Trauma:

Information on Mental Health:

Information for Families

Information for Military Children

Information on Suicide Prevention:

  • Suicide Prevention hotline – www.suicidepreventionlifeline.org; 800/273-TALK(8255) This website has a chat service associated with it.
  • In January 2009, the Health Services Research and Development Service of the Department of Veterans Affairs released Strategies for Suicide Prevention in Veterans as a part of their Evidence-based Synthesis Pilot Project (http://www.hsrd.research.va.gov/publications/esp/Suicide-Prevention-2009.pdf).
  • Traumatic Brain Injury and Suicide:  Information and Resources for Clinicians (http://www.mirecc.va.gov/visn19/docs/MANUAL_Suicide_prevention_strategies_in_TBI.pdf)
  • Suicide pocket card: http://www.mentalhealth.va.gov/College/docs/Suicide_PocketCard_Magnet.pdf
  • Suicide Prevention Information:  http://www.westpalmbeach.va.gov/services/suicide_prevention.asp
  • In 2008, SAMHSA issued a White Paper on Substance Abuse and Suicide Prevention.  On pages 22-26, it lists suicide prevention-related evidence-based programs and practices (abstracted from the National Registry of Evidence-based Programs and Practices).http://www.samhsa.gov/matrix2/508SuicidePreventionPaperFinal.pdf.
  • Developed in 2008, Veteran Suicide Risk: The Role of Traumatic Brain Injury and Post-Traumatic Stress Disorder by Peter Gutierrez, Ph.D., this video teaches public and health care professionals about suicidality in veterans.  http://www.mirecc.va.gov/apps/activities/products/productDetail.asp?id=42
  • In June 2006, the Evidence-Based Interventions for Suicidal Persons Conference was held in Atlantic City, NJ, a collaboration of the VISN 3, VISN 4, and VISN 19 Mental Illness Research, Education, and Clinical Centers (MIRECCs), the VISN 2 Center of Excellence (COE), the Department of Veterans Affairs Employee Education System, and the Chesapeake Health Education Program, Inc. (CHEP). Four DVDs resulted in the areas of Pharmacologic Interventions (Herbert Meltzer, J. John Mann), the Consumer Perspective (Fred Frese), Interpersonal Psychotherapy (Mark Miller), Dialectical Behavior Therapy (Beth Brodsky) and Cognitive Behavioral Therapy/Latest Research Findings (Gregory Brown, Amy Wenzel). *A single DVD containing only the Consumer Perspective is also available. http://www.mirecc.va.gov/apps/activities/products/productDetail.asp?id=30.
  • TIP 50:  Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment: Treatment Improvement Protocol (TIP) Series 50Treatment Improvement Protocols (TIPs), developed by the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (HHS), are best-practices guidelines for the treatment of substance use disorders. CSAT draws on the experience and knowledge of clinical, research, and administrative experts to produce the TIPs, which are distributed to facilities and individuals across the country. As alcohol and drug use disorders are increasingly recognized as a major problem, the audience for the TIPs is expanding beyond public and private treatment facilities to include practitioners in mental health, criminal justice, primary care, and other healthcare and social service settings.  To see the entire TIP, click here.

Substance Abuse and Mental Health Services (SAMHSA) Resources:

  • The Substance Abuse and Mental Health Services (SAMHSA) provides resources for returning veterans and their families:  http://www.samhsa.gov/vets/
  • SAMHSA publishes a series of Treatment Improvement Protocols (TIPs; http://www.kap.samhsa.gov/products/manuals/tips/numerical.htm) on topics such as depression, co-occurring disorders, clinical issues in intensive outpatient treatment, group therapy, substance abuse treatment for individuals with HIV/AIDS, and integrating substance abuse treatment and vocational services.  TIPs are available at no cost and may be downloaded or ordered online for mail delivery.SAMHSA publishes a series of Technical Assistance Publications (TAPs; http://kap.samhsa.gov/products/manuals/taps/index.htm).  These manuals, guidelines, and checklists address issues such as counseling competencies for providers and their supervisors, monitoring alcohol and other drug confidentiality compliance, and welfare reform and substance abuse treatment confidentiality.  TAPs are available at no cost and may be downloaded or ordered online for mail delivery.
  • SAMHSA offers five implementation resource kits in mental health—assertive community teams (ACT), family psycho-education, illness management and recovery (IMR), integrated dual disorder treatment (IDDT), and supported employment (http://mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits/default.asp).
  • SAMHSA houses the National Registry of Evidence-based Programs and Practices (http://www.nrepp.samhsa.gov/).  NREPP is a searchable database of interventions for the prevention and treatment of mental illness and substance use disorders. SAMHSA has developed this resource to help people, agencies, and organizations implement programs and practices in their communities.

Centers on Evidence-based Practices:

  • The Department of Veterans Affairs also has a Center of Excellence on Implementing Evidence-Based Practices (www.ciebp.research.va.gov).  While this site did not list EBPs per se, it did list current research studies that they are currently contracting, including the following:
    • Illness Management and Recovery for Veterans with Severe Mental Illness
  • MIRECC, Department of Veterans Affairs, has identified evidence-based treatments, including the following (http://www.mirecc.va.gov/apps/activities/products/keywordProductList.asp?id=6):
    • Family psychoeducation includes accessible implementation strategies, clinical supervision, and program evaluation methods.
    • 4-DVD set on suicide prevention:  Pharmacologic Interventions (Herbert Meltzer, J. John Mann), the Consumer Perspective (Fred Frese), Interpersonal Psychotherapy (Mark Miller), Dialectical Behavior Therapy (Beth Brodsky) and Cognitive Behavioral Therapy/Latest Research Findings (Gregory Brown, Amy Wenzel).
    • CBT for Psychosis is an implementation trial that occurred in VISN 3, examining the effectiveness of the therapy and methods for training staff in this therapy
    • Veteran Suicide Risk: The Role of Traumatic Brain Injury and Post-Traumatic Stress Disorder, video to teach the public and health professionals about suicidality in veterans
    • Quick Guides for Providers on Traumatic Brain Injury (both handout and pocket card formats)
    • Taber K, Hurley R.  PTSD and Combat-Related Injuries:  Functional Neuroanatomy, Journal of Neuropsychiatry and Clinical Neuroscience, 2009.
    • Robin Hurley, M.D. prepared an overview of traumatic brain injury from the clinical perspective.
    • Video, Pharmacist Medication Counseling for TBI, that provides tools for pharmacist to facilitate knowledgeable and effective drug use by brain injured veterans.
    • Video, Visual Disorders in Brain Injury, which provides an overview of the common visual disorders of individuals with brain injury and the optometric evaluation and visual rehabilitation treatment options.
    • A Therapist’s Guide to Brief Cognitive Behavioral Therapy, is “designed to show how CBT can be adapted to brief sessions in medical settings such as primary care. The manual is composed of skill modules. This manual is not intended to produce competence in CBT but to support existing training and supervision in CBT.”
    • DVD, Preparing Veterans for Group Psychotherapy, provides “an orientation to group therapy, with veterans discussing their experiences in group psychotherapy and how this treatment has been helpful.”
    • The Technology Model: An Introduction to Psychotherapy Research in Substance Abuse is a “manual for clinicians and researchers which focuses on the methods and models currently used to evaluate the effectiveness of psychosocial treatments. The core elements of the Technology Model include specification of treatment in manuals; selection, training, and supervision of therapists; and monitoring of treatment delivery to assess adherence and competence.”
    • The Yale Adherence and Competence Scale (YACS) Guidelines is a manual that includes” general guidelines for rating adherence and competence of treatment delivery as well as specific items and rating guidelines developed for assessment, general support, goals for treatment, and supplemental items. Rating guidelines are also included for specific treatments such as clinical management; twelve step facilitation; and cognitive behavioral treatment.”
  • Veterans Evidence-Based Research Dissemination Implementation Center (VERDICT)
    VERDICT’s mission is to foster a knowledge-based health care system in which clinical, managerial, and policy decisions are based upon sound information from research findings. The multidisciplinary team addresses systematic implementation of evidence in clinical practice within the Veterans Health Administration, leading to integrated models of care and improved service, quality and efficiency. The primary academic affiliate is the University of Texas Health Science Center at San Antonio.  UT Health Science Center investigators were recently awarded a $25 million grant from the Department of Defense (DoD) to lead a research consortium “STRONG STAR” in which VERDICT is participating to study post-traumatic stress disorder among veterans returning from Iraq and Afghanistan. San Antonio is also home to the San Antonio Military Medical Center (formed from Brooke Army Medical Center and Wilford Hall Medical Center) and the United States Army Institute of Surgical Research, which respectively serve as one of the major trauma centers and the only burn center for all military personnel worldwide.  http://www.verdict.research.va.gov/.

Department of Veterans Affairs

The Office of Quality and Performance, Department of Veterans Affairs, issues clinical practice guidelines (CPGs) in a variety of health and behavioral health topics, including depression, post-traumatic stress disorder, and substance use disorders (http://www.healthquality.va.gov/).  This Office also recommends specific practices.

Information and Support After a Suicide Attempt:  http://www.mirecc.va.gov/visn19/docs/ResourceGuideFamilymembers.pdf

Mental Illness Research, Education and Clinical Centers (MIRECC):  http://www.mirecc.va.gov/index.asp
Established by Congress, MIRECCs conduct research into the causes and treatments of mental disorders and uses education to put new knowledge into routine clinical practice in the VA.  Their website lists manuals and clinical workbooks for clinicians.

Women’s Trauma Recovery Program (WTRP) – http://www.womenvetsptsd.va.gov/WTRP_Curriculum.asp

VA Polytrauma System of Care:  http://www.polytrauma.va.gov

Department of Veterans Affairs Pocket Guides:

TOOL KIT

Engaging Veterans and Families to Enhance Service Delivery: A Tool Kit for Community-Based Organizations, released by The National Center on Family Homelessness, discusses the impact of PTSD and traumatic brain injury (TBI). It also provides useful tools for veteran outreach, including understanding the unique experiences of female veterans, and maximizing veteran participation in programs and services through social media