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Providing Care for Comorbid Mental Health Conditions in the Polytrauma System of Care

Pastorek, Nicholas J., PhD; Petska, Kelly S., PhD; Duchnick, Jennifer J., PhD; Chard, Kathleen M., PhD; Belanger, Heather G., PhD

Section Editor(s): Cornis-Pop, Micaela PhD; Scholten, Joel MD

The Journal of Head Trauma Rehabilitation: May/June 2019 - Volume 34 - Issue 3 - p 150–157
doi: 10.1097/HTR.0000000000000480
VA Polytrauma Transitional Rehabilitation Programs

Objective: To summarize challenges and best practices relevant to providing care for mental health comorbidities in veterans and service members (V/SM) treated in the Polytrauma System of Care (PSC) and to review themes that emerged during a May 2017 meeting of rehabilitation professionals on this topic. Management of comorbid mental health conditions remains a critical issue within the PSC, given the high rate of these comorbidities and the impact of mental health conditions on treatment planning and outcomes.

Design: To identify the challenges of concomitantly treating TBI-related symptoms and mental health comorbidities in V/SM treated within the PSC, describe specialty programs within the Veterans Health Administration designed to treat these comorbid conditions, and report on the themes and recommendations identified by rehabilitation professionals at the 2017 meeting.

Conclusion: To further develop mental health treatment within the PSC, the following recommendations were made: (1) continued support for family members as critical members of the rehabilitation team; (2) adding measures and mechanisms to monitor mental health within the PSC; and (3) exploration of modern technologies to enhance care of existing polytrauma clients and to better prepare to serve clients with all types of acquired brain injury.

Michael E. DeBakey VA Medical Center, Houston, Texas (Dr Pastorek); Baylor College of Medicine, Houston, Texas (Dr Pastorek); Minneapolis VA Health Care System, Minneapolis, Minnesota (Dr Petska); James A. Haley Veterans Affairs Medical Center, Tampa, Florida (Dr Duchnick); Trauma Recovery Center, Cincinnati VA Medical Center, Cincinnati, Ohio (Dr Chard); Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, Ohio (Dr Chard); Defense and Veterans Brain Injury Center (DVBIC), Tampa, Florida (Dr Belanger); United States Special Operations Command (USSOCOM) (Dr Belanger); and University of South Florida (USF), Tampa (Dr Belanger).

Corresponding Author: Nicholas J. Pastorek, PhD, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd (RECL 117), Houston, TX 77030 (

This work was supported by Veterans Health Administration, US Department of Veterans Affairs.

Contents of this article do not represent the views of the Department of Veterans Affairs or the United States Government.

The authors declare no conflicts of interest.

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