Statement of
Miles McFall, Ph.D.
Director, PTSD Treatment Programs
VA Puget Sound Health Care System
Before the
United States Senate
Committee on Veterans' Affairs
August 17, 2007

Good Morning, Senator Murray.  Thank you for the opportunity to discuss VA Puget Sound Health Care System's service to veterans with stress-related mental disorders.  I would like to request my statement be submitted for the record.  I will begin by discussing our medical center's specialized mental health programs, then later move to our outreach and research plans.

VA Puget Sound hosts an array of complementary clinical treatment programs uniquely tailored to the needs of veterans from all eras of military service.

1. Our Post-Traumatic Stress Disorder (PTSD) Outpatient Clinics offer a full spectrum of care including pharmacological, psychotherapeutic, and case management interventions.  During FY06 we treated more than 3,400 veterans, approximately 15 percent of whom were women.  Our women veterans are cared for by a specialized team of therapists from our Women's Trauma Program.

2. The PTSD Inpatient Program is a 12-bed inpatient PTSD program for veterans in VISN 20.  The PTSD Inpatient Program provided comprehensive intensive inpatient psychiatric and medical care to 259 veterans with PTSD and related disorders in FY06.  OIF/OEF veterans - more than 110 so far - increasingly rely on this program because it simultaneously evaluates and treats both PTSD and Traumatic Brain Injury (TBI), in collaboration with our Polytrauma program.

3. The PTSD Domiciliary serves about 100 veterans annually, provides extended care for veterans discharged from the PTSD Inpatient Program, and is an alternative to intensive inpatient care.  Veterans receive rehabilitation and recovery-oriented interventions designed to help them gain stability, cope with chronic symptoms, avert homelessness, engage in activation-oriented programs to counter social isolation, and access case management services.

4. Deployment Health Clinics (DHC) are the hub of specialized post-combat care for most OIF/OEF veterans at our facility.  The DHC provides primary medical care and mental health services (provided by PTSD program staff) in a single setting, improves access to care, and allows VA to coordinate care with essential support services.  The Seattle DHC has seen about 700 veterans and the American Lake DHC has seen about 500 veterans.

5. VAPSHCS Liaisons and PTSD Program staff collaborate with Madigan Army Medical Center, Vet Centers and the Washington Department of Veterans Affairs (WDVA) to support a system of care for veterans with military-related stress disorders.  Recently, VA Puget Sound PTSD programs deployed psychiatric staff to three Vet Centers in western Washington and used telemedicine to follow patients in these settings.  Additionally, active duty service members utilize our PTSD programs, particularly the PTSD Inpatient Program and DHCs, after referral by Madigan Army Medical Center and other DoD installations.

 VA is conducting aggressive outreach with WDVA, the Washington State National Guard, and a host of other federal and state agencies because early intervention for OIF/OEF veterans is the best method for preventing normal readjustment responses which can, in certain instances, solidify into chronic PTSD.  Mental health staff from VHA facilities in Washington provided screening, counseling, and education to nearly 3,000 active duty service members during 32 "Family Activity Day" events since 2005.

 PTSD Research is vital to providing the best care possible to our veterans and service members.  VA Puget Sound research investigators have amassed over $23 million in competitive research funds from VA, the Department of Defense (DoD), and the National Institutes of Health (NIH) and have published more than 60 scientific papers on underlying mechanisms and treatment approaches for PTSD.

This concludes my testimony.  Thank you for the opportunity to appear before you today, Senator Murray.  I would be happy to answer any questions you may have.