A5070476741- Posttraumatic Stress Disorder Research
- Suicide and Self-Harm Studies
- Mental Health Treatment and Access
- Traumatic Brain Injury Research
- Migration, Health and Trauma
- Treatment of Major Depression
- Mental Health via Writing
- Emergency and Acute Care Studies
- Healthcare professionals’ stress and burnout
- Health disparities and outcomes
- Primary Care and Health Outcomes
- Resilience and Mental Health
- Healthcare Policy and Management
- Electroconvulsive Therapy Studies
- Schizophrenia research and treatment
- Opioid Use Disorder Treatment
- Health Policy Implementation Science
- Substance Abuse Treatment and Outcomes
- Psychotherapy Techniques and Applications
- Maternal Mental Health During Pregnancy and Postpartum
- Patient Safety and Medication Errors
- Patient Satisfaction in Healthcare
- Healthcare Decision-Making and Restraints
- Healthcare Operations and Scheduling Optimization
- Health Systems, Economic Evaluations, Quality of Life
Dartmouth College
2016-2025
White River Junction VA Medical Center
2016-2025
National Center for Post Traumatic Stress Disorder
2012-2025
University of Vermont
2024-2025
Boston University
2025
Dartmouth Institute for Health Policy and Clinical Practice
2010-2024
National Center for PTSD
2019-2024
FrontLine Service
2021-2024
Hartford Financial Services (United States)
2019-2023
Behavioral Health Services
2022
The U.S. Department of Veterans Affairs (VA) and Defense (DoD) worked together to revise the 2017 VA/DoD Clinical Practice Guideline for Management Posttraumatic Stress Disorder Acute Disorder. This article summarizes 2023 clinical practice guideline (CPG) its development process, focusing on assessments treatments which evidence was sufficient support a recommendation or against.
We developed linguistics-driven prediction models to estimate the risk of suicide. These were generated from unstructured clinical notes taken a national sample U.S. Veterans Administration (VA) medical records. created three matched cohorts: veterans who committed suicide, used mental health services and did not commit use suicide during observation period (n = 70 in each group). From notes, we datasets single keywords multi-word phrases, constructed using machine-learning algorithm based...
Objectives: Barriers associated with the decision not to seek treatment for symptoms of combat-related posttraumatic stress disorder (PTSD) were examined. Methods: Participants 143 military men and women who served in Operation Enduring Freedom or Iraqi (OEF/OIF) screened positive (PTSD), as assessed by PTSD Checklist–Military Version, had sought PTSD. During a cognitive-behavioral telephone intervention, participants asked about their beliefs concerning seeking treatment. Results: Four...
Objective The U.S. Department of Veterans Affairs (VA) has engaged in substantial efforts to promote the use evidence-based psychotherapies for posttraumatic stress disorder (PTSD). authors evaluated effectiveness these efforts. Methods This study used a cross-sectional, mixed-methods evaluation treatment provided by VA at specialty PTSD clinics New England during first six months fiscal year 2010. Natural language processing algorithms were applied clinical notes determine utilization...
Abstract Background This study evaluated whether natural language processing (NLP) of psychotherapy note text provides additional accuracy over and above currently used suicide prediction models. Methods We a cohort Veterans Health Administration (VHA) users diagnosed with post-traumatic stress disorder (PTSD) between 2004–2013. Using case-control design, cases (those that died by during the year following diagnosis) were matched to controls remained alive). After selecting conditional...
Understanding the effectiveness of medication treatment for opioid use disorder to decrease risk suicide mortality may inform clinical and policy decisions. The authors sought describe effect medications (MOUD) on mortality.This was a retrospective cohort study in Department Veterans Affairs (VA) patients from 2003 2017. linked three data sources: VA Corporate Data Warehouse, Centers Medicare Medicaid Services Claims Data, VA-Department Defense Mortality Repository. exposure interest MOUD,...
ABSTRACT Introduction Maintaining accurate race and ethnicity data among patients of the Veterans Affairs (VA) healthcare system has historically been a challenge. This work expands on previous efforts to optimize values by combining multiple VA sources exploring race- ethnicity-specific collation algorithms. Materials Methods We linked patient from 2000 2018 with four administrative electronic health record sources: Medical SAS files (MedSAS), Corporate Data Warehouse (CDW), Centers for...
Sedentary lifestyle, poor dietary behaviors and metabolic alterations associated with psychiatric medications contribute to health high rates of obesity among individuals serious mental illness (SMI). Interventions that increase engagement in physical exercise, modifications, lifestyle changes preventive care can provide benefits across the lifespan. These interventions have led substantial improvements some persons SMI, while others not improved or experienced worsening health. We set out...
In the past two decades a great deal of research has demonstrated improved quality care when mental health is integrated into primary care. To date, most literature addressed management for specific illnesses. Such programs can be difficult to implement and sustain. We describe program "Colocated Collaborative Care," implemented in 2004 that been sustained grown over 6 years since inception. The Primary Mental Health Care clinic at White River Junction (Vermont) Veterans Affairs Medical...
Background Although evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD) were implemented starting in 2005 the veterans health administration (VHA), largest national healthcare system U.S., rate of initiation (uptake) and prevalence these treatments each calendar year have not been determined. We aimed to elucidate two metrics EBP utilization, uptake prevalence, following implementation. Methods Cohort study Iraq Afghanistan VHA (N = 181,620) with a PTSD diagnosis...
Patients diagnosed with attention-deficit hyperactivity disorder (ADHD) are at an elevated risk for suicide. No prior work has assessed the association between stimulant prescriptions and death by suicide in this population. This retrospective cohort study included Department of Veterans Affairs patients active ADHD diagnosis that received medications 2016 2019. We found months medication prescription was associated decreased mortality compared without (odds ratio 0.57, 95% CI 0.36–0.88)....
Objective: Despite long-standing interest in posttraumatic stress disorder (PTSD) and opioid use comorbidity, there is a paucity of data on the prevalence patients with PTSD. Therefore, limited understanding medications for this population. We determined diagnosed large cohort Methods: obtained administrative pharmacy veterans who initiated PTSD treatment Department Veterans Affairs (VA) between 2004 2013 (N = 731,520). identified those comorbid diagnosis (2.7%; n 19,998) whether they...
Abstract Objective Vast efforts are directed toward curing or prolonging the life of patients with cancer. However, less attention is given to mental health aspects cancer care, and there elevated incidence death by suicide in this population. Evaluating Root Cause Analyses (RCAs) cancer‐related suicides may further our understanding system‐level factors that contribute highlight strategies mitigate risk. Methods We searched Veterans Health Administration National Center for Patient Safety...
Abstract Rationale aims and objectives As quality measurement becomes increasingly reliant on the availability of structured electronic medical record (EMR) data, clinicians are asked to perform documentation using tools that facilitate data capture. These may not be available, feasible, or acceptable in all clinical scenarios. Alternative methods assessment, including natural language processing (NLP) notes, improve completeness real‐world practice. Our objective was measure care for a set...