Written by Lt. Michael J. Doria, Ph.D., Clinical Neuropsychologist, Program Manager, Psychological Health & Traumatic Brain Injury Program.
Congress has designated March as Brain Injury Awareness Month. To raise awareness of traumatic brain injury, the U.S. Coast Guard, along with the Department of Homeland Security and the Department of Defense, promotes an educational campaign regarding TBI throughout the month.
TBI can be insidious in its progression and subtle impact on affected individuals, degrading interpersonal relationships, individual cognitive function and the ability to support one’s self and family. Improving outcomes for TBI-affected individuals and reducing its impact on the organization begins with awareness and recognition.
“TBI awareness is key to the early recognition and appropriate treatment of TBI to promote recovery and restore members to mission readiness,” states Rear Adm. Maura Dollymore, M.D., director of Health and Safety for the Coast Guard.
According to the Brain Injury Association of America and the Centers for Disease Control and Prevention, 1.7 million people in the United States sustain a TBI every year, with brain injury being a contributing factor to 30.5 percent of all injury-related deaths in the United States.
In short, TBI is a blow or jolt to the head or a penetrating head injury that disrupts the function of the brain. It can cause a wide range of functional changes that can affect thinking, sensation, movement, language or emotions.
From 2000 to 2013, more than 287,000 U.S. armed force servicemembers sustained a TBI. Approximately, 84 percent of those injuries were mild TBIs, otherwise known as concussions, according to the Defense and Veterans Brain Injury Center.
DVBIC was created in 1992 by an act of Congress in order to better care for service members who sustained a TBI. DVBIC is the TBI operational component of the Defense Center of Excellence for Psychological and Traumatic Brain Injury.
“DVBIC has sixteen sites around the world working with brain injured patients from each branch of the armed services,” said U.S. Army Col. Sidney R. Hinds II, M.D., national director of DVBIC. “This joint effort allows us to use the experts in every area of TBI research, treatment, and clinical care so we can offer the best and most up-to-date care and technology to our wounded warriors.”
According to DVBIC, recovery from a mild TBI is usually complete within seven to 10 days.
Despite having a smaller footprint than the other military services, the Coast Guard is faced with similar head injuries whether in combat settings, at home station or on other deployments. These injuries can occur to anyone at any time.
For the Coast Guard specifically, a key fact about military brain trauma is that nearly 98 percent of them occur in non-deployed operations. Similarly for DOD, more than 80 percent are non-combat related. The epidemiology of both deployment and non-deployment related TBI remains poorly understood despite the potential harmful effects for service members.
When an individual sustains a TBI, the entire family can also be affected. Caregivers of people who have suffered a TBI experience feelings of burden, distress, anxiety, anger and depression. If you are caring for a partner, spouse, child, relative or close friend with TBI, it is important to recognize how stressful this situation can be. Seeking help is the key!
The National Center on Caregiving states that, “some services most helpful [to caregivers] include in-home assistance, respite care to provide breaks from care giving, brain injury support groups, and ongoing or short-term counseling for caregivers to adjust to the life changes. Caregivers may also need to ask their support system of family, friends and community members for help, so they can avoid burn out.”
A crucial resource for individuals with TBI and their caregivers in the military community is the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, which provides health care professionals with evidence-based psychological health and traumatic brain injury care guidelines and consultation.
In October 2012, the Office of Health, Safety and Work-Life‘s, Operational Medicine and Medical Readiness established the Coast Guard’s Psychological Health and TBI Program, which is comprised of two service-wide comprehensive, inter-disciplinary programs focused on prevention, training, treatment and tracking of psychological health and TBI cases, as well as promoting total health across the entire service. Furthermore, these programs advocate that all personnel with injuries receive the best evaluation, treatment and follow-up care from the DOD and the Department of Veterans Affairs health care systems.
The psychological health and TBI program designed and developed Continuing Medical Education accredited curricula for five new DOD approved psychological health and TBI courses that include the use and interpretation of the Military Acute Concussion Evaluation tool and developed the Coast Guard Policy on Concussed Patient System of Care in the non-deployed setting. Face-to-face training for all Coast Guard and other DOD medical providers at more than 30 clinics throughout the country to include Puerto Rico, Alaska and Hawaii resulted in Coast Guard providers’ maintenance of operational proficiency.
Advanced TBI instructional training was also conducted for Coast Guard Training Center Cape May’s company commanders and for the Coast Guard Academy’s athletic department coaches. The Coast Guard’s first-ever TBI awareness training video, featuring more than 15 units, and both internal and external leadership interviews aims to address the risks, signs and symptoms in those who sustain a TBI, as well as the importance of identifying and seeking help.
For the first time, a direct 24-hour, 7-day-a-week neuropsychological consultation contact for immediate response to Coast Guard medical providers was established, in addition to a general informational email address regarding any questions, concerns or request for psychological health and TBI educational materials that can be accessed by the entire Coast Guard family at email@example.com was implemented.
The program has also expanded its efforts to care for its service personnel while promoting tri-service and tri-agency research opportunities within its operational community.
For further information on Brain Injury Awareness Month please visit DVBIC’s website at: http://www.dvbic.dcoe.mil. For further information on the CG’s Psychological Health and Traumatic Brain Injury Program please email firstname.lastname@example.org.