Monday, March 16, 2009

Researchers urge sweeping TBI care changes

Researchers urge sweeping TBI care changes

By Kelly Kennedy - Staff writer
Posted : Thursday Mar 12, 2009 21:31:19 EDT

A team sponsored by the Congressional Brain Injury Task Force released a report Thursday stating that mental and traumatic brain injury health issues should be handled by the secretary of defense so they can be more quickly addressed, and recommended that Congress appropriate $350 million to fund a list of other proposals that the team laid out.

The report states that more research needs to be done to learn how to protect the brain, to discover exactly how a blast affects the brain and to understand how brains can recover from such injuries.

The International Conference on Behavioral Health and Traumatic Brain Injury also recommended a public awareness campaign, better benefits for the family caregivers who take care of troops with brain injuries, specific standards for treatment, and better assessment tools — especially in the war zones.

None of the recommendations from the task force team are new and most are already being worked on or recommended by other committees. But the 60 or signatures of brain injury experts at the bottom of the report keeps the spotlight on what has been called the “signature wound” of the wars in Iraq and Afghanistan. The researchers asked for immediate “consideration and action” from the Defense Department and Congress. As many as 320,000 troops have had a traumatic brain injury, the Rand Corp. think tank reported last year

“The military has made great strides to better prevent, identify and treat TBIs and behavioral health issues among our brave men and women in uniform, but there is still room for progress, and the public remains interested and invested in the implementation of these improvements,” wrote Rep. Bill Pascrell, D-N.J., co-chair of the Congressional Brain Injury Task Force, in the introduction to the report.

The team was made up of dozens of doctors focused on cures, barriers, and screening for TBI.

Pascrell noted that addressing the issue as soon as possible is important in order to keep down the long-term costs of untreated injuries, which could lead to unemployment, homelessness, divorce and other mental health issues.

The report asks the military to work with the Department of Veterans Affairs, civilian universities and research institutes to develop neuro-protection for the brain, look at how a blast affects the brain both short- and long-term, develop ways to check progress on an injury, and research individual differences in recovery.

The report also recommends creating a public service awareness campaign to educate the nation about brain injuries, developing one centralized help line, establishing one referral point for wounded troops and their families, and expanding care coordination across the country. Researchers also asked that all military health care workers be educated about TBI and psychological health.

They recommended a Web-based screening system for troops to use in theater to diagnose TBIs, as well as to see if a person is ready to return to duty. For medics, they said a standardized assessment battery should be developed that is symptom-based.

The report says that families should have a rural network support system so they can easily get information; mentors or coaches to help them as they adjust to life with a brain-injured family member; temporary housing provided if they have to relocate to be near an injured family member; and education programs for children should be developed.

They also recommend that mild TBI and post-traumatic stress disorder should be “clearly defined” and that specific guidelines for evidence-base treatment be created. They also recommended neuro-bahavioral interventions to make sure the injuries don’t lead to social problems, such as divorce, substance abuse, homelessness or suicide.

Many of the goals have already been achieved or are in process by the Defense Department, but the committee recommended that they move more quickly to offer the best care.

“To achieve this overarching goal, it is imperative that DoD reorganize the Office of Health Affairs to respond more quickly and decisively to the emergent needs of wounded warriors and to implement the latest advances in research and cutting-edge technology in the most timely manner,” the report states. “We strongly urge that the Defense Center of Excellence for TBI be placed within the Office of the Secretary of Defense in order to successfully execute these recommendations.”

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