(PS6-D80) Ten Years of Evidence Based Practice with Veterans and Military Families

The conflict in Iraq and Afghanistan resulted in significant physical casualties and invisible wounds of war.  It is estimated that 15% of veterans deployed are diagnosed with Posttraumatic Stress Disorder (PTSD) (Dursa, et al., 2014) and 17-22% with Traumatic Brain Injury (TBI) (Lindquist et al., 2017). Military service not only impacts veterans; deployment-related stressors are also associated with depression, anxiety, and behavior problems in military families and children (Jensen et al., 1996; Kelley, 1994 Rentz et al., 2006). There is an ongoing need to address mental health concerns in this population. It has been reported approximately 40-60% of veterans who may benefit were unable to access mental healthcare (Hoge et al., 2004; Kehle et al., 2010), for reasons such as ineligibility for services at Veteran Affairs (VA) Hospitals. Furthermore, most family members are not able to receive VA care or have challenges finding private providers with military cultural knowledge and competence (Tanielian et al., 2018).

Founded in 2012 to address gaps in care, the Steven A. Cohen Military Family Center (MFC) at NYU Langone Health provides pro bono, evidence based and culturally attuned individual, couples, family, group therapy, and psychiatry for veterans and family members regardless of discharge status, combat exposure, or era served. MFC offers therapies including Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), Trauma Focused CBT (TF-CBT), Acceptance and Commitment Therapy (ACT), Written Exposure Therapy (WET), Dialectical Behavioral Therapy (DBT) skills, and Skills Training in Affective and Interpersonal Regulation (STAIR). MFC has also developed specialty programs including the TBI & ADHD Program, the Child & Family Program, and the Dual Diagnosis Program. Additionally, faculty have trained over 75 students including clinical psychology externs and interns, post-doctoral fellows, medical students, and medical residents to further enhance availability of military informed care across settings.

Examining the past 10 years of who accessed this no cost care for veterans and military family in New York City may provide insight into areas of need for options to augment military healthcare and the VA. In the past decade, 2535 veterans and 1035 family members presented to the MFC for mental health care with co-occurring diagnoses including, but not limited to: PTSD (27%), Adjustment Disorder (26%), Depressive Disorders (26%), Relationship Distress (29%), Substance Use Disorders (23%), Anxiety Disorders (23%), and ADHD (13%). Patients identified as White (35%), Black (20%), other/more than one race (20%), Latinx/e (18%), or Asian (4%).

 Data support effectiveness, with significant reductions in validated measures of symptom severity across pre- and post-treatment, including symptoms of PTSD (n=935, p< .0001), depression (n=1326, p< .001), anxiety (n=1343, p< .001), and relationship distress (n=491, p< .001). Qualitative feedback revealed MFC patients are appreciative of culturally competent mental healthcare.  These findings lend evidence for a needed and effective approach to filling gaps in access to military informed effective care for veterans and military families.