Peer-Reviewed Journal on "Bvamc Mhnp Residency a Joint"

Peer-Reviewed Journal 4 pages (1160 words) Sources: 4

[EXCERPT] . . . .

There is also a growing incidence of comorbid severe traumatic brain injuries associated with cases of PTSD among returning combat veterans from the wars in Iraq and Afghanistan (Capehart & Bass, 2012). The causal connection between service in the military and PTSD has been well documented. For instance, according to Bleich and Solomon (2008), "Unlike other psychiatric disorders, PTSD is, by definition, related etiologically to an identified (traumatic) factor. Hence, the causal link between PTSD and military service can be clearly established" (p. 269). The implications of these trends are severe and profound. The DSM-IV reports that PTSD is characterized by posttraumatic stress symptoms including: (a) repeated re-experiencing of the traumatic event (unwanted intrusion of trauma-related material into conscious thoughts, mental images, and dreams), (b) numbing of responsiveness to or reduced involvement with the external world (trauma- related avoidance responses), and (c) a variety of autonomic, affective, and cognitive signs of hyperarousal (Svetlicky, Solomon, Benbenishty & Levi, 2010).

Complicating the treatment of these returning combat veterans for mental health problems further is the organizational culture that exists in the U.S. armed forces. In this regard, Bond (2011) emphasizes that, "Military training is intended to rebuild individuals into a group-based culture which translates into a 'warrior culture' which creates barriers and confusion preventing some soldiers from obtaining the mental and emotional help they need for combat trauma" (p. 80). This combination of urgent need and a "warrior culture" constraint is also cited by Miller (2013) who reports, "Combat PTSD is the result of a medical condition that affects identity, and the indoctrination that comes with military training and the higher rate of exposure to trauma make combat PTSD a more difficult paradoxical problem" (p. 93). These are important issues because recent studies by the U.S. Army have found that more veterans have committed suicide following their return from a combat tour in the Middle East than were killed in combat in Afghanistan (Miller, 2013). Today, the VA is charged with providing care to those who have borne the battle (Kappelman, 2011), but our veterans are particularly challenged now that there is a spectrum of traumatic brain injury as well as post-traumatic stress injury.

We propose to increase the number of MHNPs within the Department of Veterans Affairs through the development of specialty trained, post graduate MHNPs who will focus on the mental health needs of veterans. At this time, although MHNPs become certified after graduation by the American Nurses Credentialing Center, some lack the depth of experience necessary to provide the highest level of care. Thus, the BVAMC and the UAB SON propose to collaborate on a VA-MHNP residency.

The BVAMC serves about 65,000 veterans each year; of these, approximately 17,000 receive direct care from a dedicated mental health provider. Of particular note, there are approximately 410,000 veterans in the State of Alabama based on 2011 veterans' population data provided by the U.S. Census Bureau and the U.S. Department of Veterans Affairs. The Alabama Army National Guard is currently the sixth largest Guard in the nation and is first per capita with more than 11,000 soldiers. Another 2,000 Alabamians serve in the Alabama Air National Guard. Currently, more than 1,000 Alabama Army National Guard soldiers are deployed overseas, most of them in the… READ MORE

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