David Smelson, Psy.D.

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Nov 12, 2013 (3 years and 8 months ago)

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David Smelson, Psy.D.

Professor of Psychiatry

Vice Chair for Clinical Research

Department of Psychiatry

University of Massachusetts Medical School

Director, Bedford Node

National Center on Homelessness Among
Veterans

The mission of the National Center on Homelessness Among
Veterans is to promote recovery
-
oriented care for Veterans who are
homeless or at
-
risk for homelessness. The Center is a national
resource that informs practices designed to meet the VA’s Five Year
Plan to End Homelessness among Veterans.

Background

“President Obama and I are personally committed to ending homelessness
among Veterans. Those who have served this nation as a Veteran should never
find themselves on the street, living without care and without hope
.”

Secretary Shinseki


End Veteran homelessness by 2015



ZERO
-
tolerance policy on homeless Veterans



1/3
rd

of homeless population were Veterans





NCHV Established in 2009 response to President Obama’s call to:

VA Funded


1.9 million annually across 3 nodes


5 years of funding

Goals


Track/Reduce Number of Homeless Veterans


Strategic Alignment


Research


Education


Clinical Care


Policy/Administration


Oversight of $801 Million Budget (Doubled 2009)

Policy Analysis
Core

Education and
Dissemination
Core

Model
Development
Core

Research and
Methodology
Core

Bedford VA

Philadelphia VA

Tampa VA

Program Cores

Bedford, MA

Model Development and Implementation Core


Test Evidenced Based Practices


Adapt Practices for Veterans


Develop New Practices


Provide Technical Assistance



Model
Development
Core

David Smelson, PsyD (Director, NCHV Bedford Node)

Gerardo Gonzalez, MD (NCHV Site PI/Director Division of Addiction Psychiatry)

Marsha Langer Ellison, PhD

(Investigator, Supported Employment/Supported Ed.)

Lisa Najavits, PhD

(Investigator, PTSD and Addictions)

Stephanie Rodrigues, PhD (Investigator, Stigma)

Matthew Chinman, Ph.D. (Investigator, Implementation Science)

Gregg DiGirolamo, PhD (Cognitive Neuroscience)

Lisa Fortuna, MD, MPH (Technology Development in TAY)

Rich Fletcher, PhD (Technology Development)

Leon Sawh, MPH (Site Project Director)

Liz Aaker (Project Director)

Julianne Siegfriedt, MA (Research Coordinator)

Emily Munoz (Program Support)

Kathryn O’Connor (Research Assistant, Technology Program)




Bedford VA/UMass Model Development Node

1. Manual Development Projects


Goal:


Standardize Practices


Dissemination Practices



Manuals to Date

1.
MISSION
-
VET Treatment Manual

2.
MISSION
-
VET Consumer Workbook


3.
Supported Education Manual

4.
HUD
-
VASH Resource Guide


https://umassmed.edu/psychiatry/VANationalCenteronHomelessnessAmongVeterans.asp


2. Co
-
Occurring Disorders Treatment Research Area


1.
MISSION
-
Vet HUD
-
VASH Implementation Study (2011
-
2015)


Use Getting To Outcomes (GTO) to Implement MISSION in 3 VISN’s


2.
HUD
-
VASH SUD Randomized Controlled Trial (2010
-
2013)


Test 3 Interventions (varying in intensity) to Augment HUD
-
VASH


3.
MISSION DIRECT VET Jail Diversion Program (2008
-
2013)


Divert Veterans and offer MISSION Services


4.
ATTOC in Homeless Residential Care


Adopt and Implement ATTOC Model for Smoking Cessation


3. Housing Placement and Retention


1.
Safe Haven


Serves severely mentally ill Veterans with co
-
occurring disorder


Does not punish relapse

2.
Housing First


Shift of focus to rapid placement of Veterans in housing and
intensive wraparound services

3.
HUD
-
VASH
Exiter

Study


Evaluation of HUD
-
VASH clients who leave program early



4. Peer Support/Supported Education Research Area

Support Education Research:

1.
Needs assessment for supported education among OIF/OEF Veterans


2. Pilot RCT of Supported Ed among OIF/OEF Veterans with PTSD


3. Pre
-
implementation Planning Supported Education Rollout in VA


Peer Support Research:

1.

Unbundling MISSION to Test Peer Support in HUD
-
VASH


2.

Peers in Homeless Medical Home Primary Care Setting




5. Anti
-
Stigma Research Area



Self
-
Stigma and Treatment Engagement

1.
Survey of self
-
stigma among co
-
occurring disorders



and homelessness Veterans


2.

Adopt “Coming Out Proud” for Veteran population


Public Stigma

1.
Public service announcement on homelessness Veterans


2.
Pilot anti
-
stigma campaign for high school students

6. Mobile Technology Development Research Area


Use of mobile technologies to enhance treatment engagement among hard
-
to
-
reach HUD
-
VASH clients via:


Current Projects:


1.
Needs assessment of technologies homeless
Veterans can access


2.
Test feasibility of text messaging to promote
treatment


3.
Real time Relapse Prevention via mobile device
& connected sensor band






Massachusetts : 2011 Doubled Reduction in Homeless Veterans




(23% Massachusetts Vs. 11% US)



*Data collected jointly by VA and HUD

Veteran Homelessness: A Supplemental Report to the 2009 & 2010 Annual Homeless Assessment Report to Congress (2009 & 2010 Ve
ter
an AHAR)



Incidence (new homeless cases)

OEF/OIF Homeless Vets (actual and at risk)
FY2002


FY2009
Questions?