The Bravery in Seeking Care:
Portland VA’s Comprehensive Care of
Returning Veterans
RACHEL KROKUS, LCSW
LEAH CHRISTENSEN, LCSW
OEF/OIF/OND PROGRAM
CAREGIVER SUPPORT PROGRAM
What are the health care needs of our
returning combat Veterans?
Our 26 y/o Combat Veteran is more likely to have:
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Physical injuries
Diagnosable mental health conditions
Unexplained symptoms with general health decline
Hearing problems
Dental problems
Psychosocial distress: marital, occupational, financial, social
Risk of injury/death from “incidental trauma”
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At least a 2-3 fold increased risk of suicide
And Veteran is much less likely to show up for his/her appointments
Most Common Conditions
Diseases of Musculoskeletal System 58%
2. Mental Health (PTSD, Depression, Substance
Abuse) 53%
3. Symptoms, Signs and Ill defined Conditions
(neurologic, cognitive, sleep, pain) 53%
1.
1.
2.
Concussion/Mild Traumatic Brain Injury
VA Health Care Utilization among OEF OIF OND Veterans Cumulative from 1st Qtr.
FY 2002-4th Qtr 2012, Released January 2013
Portland VA
 OEF/OIF/OND case management services
 Post Deployment Health Clinics – Vancouver, E.
Portland, Portland Women’s, West Linn, Hillsboro,
Salem, Bend, Dalles
 Caregiver Support Program
 Welcome Home Events
 Mental Health – counseling, psychiatry, substance abuse
treatment, suicide prevention, Veteran’s Justice Outreach, homeless
services, emergency care…..& more….
PVAMC OEF OIF OND Program Office
• OEF OIF OND Case Management Services – short-
term or long-term
• Enrollment, Scheduling, Care Coordination, Support,
Resources & Referral
• No appointment needed
• On-site VBA Representative
Post Deployment Health Clinic
 Primary Care Provider (specially trained provider
who is training in Traumatic Brain Injury screening
& specific health care needs of OEF/OIF/OND
Veterans including: environmental exposures,
musculoskeletal, dermatology.
 Case Management via OEF/OIF/OND Program
(works closely to help implement treatment
recommendations)
 Mental Health assessment available at most clinics
to triage into appropriate MH services
 Additional ancillary services
Caregiver Support Program
 General Support/Referral for All Era Caregivers
 Comprehensive Program for Post 9/11 Caregivers
 Comprehensive benefits – including stipend, health insurance,
respite, MH counseling
 Training/education
 Quarterly home visits
 Psychosocial support/supportive counseling
Caregiver Support Program
 Caregiver Support Line
 Peer support mentoring
 Monthly Education Series
 Annual Caregiver Conference
Caregiver Support Line/Website
www.caregiver.va.gov
Welcome Home Events
• Offered annually
• To Service Members who have deployed
• Family event
Case Study
 “Jason”
 25 year old
 Marine
 PTSD, TBI, bilateral knee conditions
 Married, father of 2
 Reintegration…..
Reintegration
“Re-enter or restore to unity;
often referring to the process a soldier and his/her
family undergo when the soldier returns from
deployment”
Case Discussion
Strengths…..
Challenges…..
What would you do…..
Thank you…..
 OEF/OIF/OND Program
503.273.5075
 Caregiver Support Program
503.273.5210