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Thursday, January 31, 2008

Center Gears Up to Treat Brain Injuries

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by Maj. Wayne Marotto Army News Service
Army Col. Loree Sutton is a woman on a mission.

The military psychiatrist has, for the last month, ricocheted across the Capital Beltway landscape and beyond, setting up a Defense Department office that will, for the first time, bring together the best of the best relating to psychological health and brain injury treatment.

‘‘I drink bad coffee all over this town and all over this country,” Sutton said. ‘‘I’m talking with them. I’m letting them know what we’re about, finding out how we can partner.”

The Defense Department created the Defense Center of Excellence for Psychological Health and Traumatic Brain Injury in its effort to step up the quality of care for wounded warriors and their families. It officially opened Nov. 30 and is still hiring staff and leaders. In its temporary digs just two Metro stops north of the Pentagon, yet-to-be connected computer network lines dangle from the ceiling, and some cubicles wait empty.

But that hasn’t stopped Sutton from preaching the mission of the center with an almost evangelical passion and launching the beginnings of a literal World Wide Web of clinicians, researchers, educators and leaders, from the military system, private practice and academia.

The hopes are that the center becomes the leading international resource for psychological health and brain injury education, training, research, treatment and prevention.

On any given day, Sutton attends meetings, makes presentations and networks at the Pentagon, Walter Reed Army Medical Center, the National Naval Medical Center or Uniformed Services University of the Health Sciences, and similar places around the country. This year, she said, she plans to expand her trips outside of the U.S.

‘‘Right now that’s our task, to build the team and grow the function of the office,” she said. ‘‘For us to fully reach our potential, we’ve got to be connected to that national and international network of experts who can bring the best to bear for our troops and family members.”

The Defense and Veterans Brain Injury Center, started nearly 20 years ago, serves as the new center’s foundation. That office, now at Walter Reed, has served as the department’s main hub for traumatic brain injury experts. Also, the department’s Center for Deployment Psychology, created in 2006 and housed at Uniformed Services University, will bring its training and education functions to the center.

This summer, the staffs will merge into new office space in Silver Spring, bringing the total staff size to about 100. Plans are for a new building to be built next to the site of the future Walter Reed National Military Medical Center at Bethesda in October 2009.

Then the center also will begin managing clinical treatment for brain injuries there.

Sutton’s job is a one-star general officer’s billet, which speaks to the relevance of the new center and the department’s desire to make it a lead agency. Nominated for the promotion, she is awaiting Senate confirmation.

The Defense Center of Excellence for Psychological Health and Traumatic Brain Injury is aligned under the Tricare Management Activity and acts as a Defense Department field operating agency.

The idea for the center came from the results of several military and civilian health care commissions and task forces, Sutton said. In 2006, a mental health task force talked with leaders, wounded Soldiers and family members across the service. One of the common themes, Sutton said, was that the department should bring together best practices in treatment, research, education and training.

For now, the center will not directly manage health care, policy or enforcement. Sutton said it will work with policy-making offices, and the best practices it collects from agencies worldwide will be incorporated into policy.

The center also will set standards and assess, survey and validate Defense Department programs, and decide, in part, how resources are directed, Sutton said.

Center officials are reviewing hundreds of research project proposals that hope to claim a piece of the $300 million Congress set aside last year for brain injury research. The office will also work with the military services to see which of the many programs funded with another $600 million from Congress are working and how to direct those funds to programs most beneficial to service members and families, Sutton said.

‘‘It is a team of teams in a network,” she said.

Beyond its networking efforts, the center is already providing some training, Sutton said. And her staff is working with medical commanders in the combat theater to revise traumatic brain injury protocols and treatment management practice guidelines.

In a couple of weeks, the center will have a World Wide Web presence on the Defense Department Health Affairs Web site, and staffers hope to launch a newsletter in April.

Plans are to include a 24-hour call center for referrals and information and to incorporate telehealth, the delivery of health-related services via telecommunications technologies.

The center’s efforts will also move past the medical model, Sutton said, to reach out to family and community programs with education and training. In one of its first initiatives, the center is working with a host of others such as the departments of Veterans Affairs, Labor, Education, and Health and Human Services to help reintegrate service members and their families into the community after a deployment.

‘‘For us to make sure that this center of excellence lives fully up to its potential, we’ve got to reach out way beyond services, way beyond the Defense Department ... reach out to the civilian world, both in this country and abroad. And we’re doing that,” she said.

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