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Center gears up for mental health, traumatic brain injuries

  • Published
  • By Fred W. Baker III
  • American Forces Press Service
Army Col. (Dr.) Loree Sutton is a woman on a mission.

The military psychiatrist has, for the last month, ricocheted across the Capital Beltway landscape and beyond, setting up a Defense Department office that will, for the first time, bring together the best of the best relating to psychological health and brain injury treatment.

"I drink bad coffee all over this town and all over this country ... to make sure that I am reaching out. I'm linking up with folks. I'm talking with them. I'm letting them know what we're about, finding out how we can partner," Sutton said in an interview from her temporary Rosslyn, Va., office suite.

"No two days are the same, that's for sure," she said.

The Defense Department created the Defense Center of Excellence for Psychological Health and Traumatic Brain Injury in its effort to step up the quality of care for wounded warriors and their families. It officially opened Nov. 30 and is still hiring staff and leaders. In its temporary digs just two Metro stops north of the Pentagon, yet-to-be connected computer network lines dangle from the ceiling, and some cubicles wait empty.

But that hasn't stopped Sutton from preaching the mission of the center with an almost evangelical passion and launching the beginnings of a literal worldwide web of clinicians, researchers, educators and leaders, from the military system, private practice and academia. The hopes are that the center becomes the leading international resource for all psychological health and brain injury education, training, research, treatment and prevention.

On any given day, Sutton attends meetings, makes presentations and networks at the Pentagon, Walter Reed Army Medical Center here, the National Naval Medical Center or Uniformed Services University of the Health Sciences in Bethesda, Md., and similar places around the country. This year, she said, she plans to expand her trips to outside of the United States.

"Right now that's our task, to build the team and grow the function of the office," she said. "For us to fully reach our potential, we've got to be connected to that national and international network of experts who can bring the best to bear for our troops and family members."

The Defense and Veterans Brain Injury Center, started nearly 20 years ago, serves as the foundation for the new center. That office, its headquarters now at Walter Reed, has served as the department's main hub for traumatic brain injury experts. Also, the department's Center for Deployment Psychology, created in 2006 and housed at the Uniformed Services University of the Health Sciences, will bring its training and education functions to the center.

This summer, the staffs will merge into new office space in Silver Spring, Md., bringing the total staff size to about 100. Plans are for a new building to be built next to the site of the future Walter Reed National Military Medical Center at Bethesda in October 2009. Then the center also will begin managing clinical treatment for brain injuries there.

Sutton's job is a one-star general officer's billet, which speaks to the relevance of the new center and the department's desire to make it a lead agency. Nominated for the promotion, she is awaiting Senate confirmation.

The Defense Center of Excellence for Psychological Health and Traumatic Brain Injury is aligned under the Tricare Management Activity and acts as a DoD field operating agency. Sutton reports directly to Assistant Secretary of Defense for Health Affairs Dr. S. Ward Casscells, who also directs Tricare Management Activity.

The idea for the center came from the results of several military and civilian health care commissions and task forces, Sutton said. In 2006, a mental health task force talked with leaders, wounded soldiers and family members across the service. One of the common themes, Sutton said, was that the department should bring together best practices in treatment, research, education and training.

For now, the center will not directly manage health care, policy or enforcement. Sutton said it will work with policy-making offices, and the best practices it collects from agencies worldwide will be incorporated into policy.

The center also will set standards and assess, survey and validate DoD programs, and decide, in part, how resources are directed, Sutton said.

Center officials are reviewing hundreds of research project proposals that hope to claim a piece of the $300 million set aside by Congress last year for brain injury research. The office also will work with the military services to see which of the many programs funded with another $600 million from Congress are working and how to direct those funds to programs most beneficial to servicemembers and families, Sutton said.

But Sutton emphasized that the office's efforts don't center on command and control of programs and funds, but rather more on forming a network of partnerships and working together to agree on best practices for treatment.

"It is a team of teams in a network," she said.

Beyond its networking efforts, the center also already is providing some training, Sutton said. And her staff is working with medical commanders in the combat theater to revise traumatic brain injury protocols and treatment management practice guidelines.

In a couple of weeks, the center will have a World Wide Web presence on the DoD Health Affairs site, and staffers hope to launch a newsletter in April.

A strategic planning conference is in the works for February, bringing together about 150 industry leaders in both the civilian and military markets.

Plans are to include a 24-hour call center for referrals and information and to incorporate telehealth, the delivery of health-related services via telecommunications technologies.

The center's efforts also will move past the medical model, Sutton said, to reach out to the family and community programs with education and training. In one of its first initiatives, the center is working with a host of others such as the departments of Veterans Affairs, Labor, Education, and Health and Human Services on a program to help reintegrate servicemembers and their families into the community after a deployment.

"None of us have all the answers, but together we will absolutely do the right thing and provide the best possible care for our troops and their families," Sutton said.

Even when the final move is made to its newly constructed building on the Bethesda campus in 2009, Sutton emphasized, the power of the organization will not be held within its brick-and-mortar walls.

"For us to make sure that this center of excellence lives fully up to its potential, we've got to reach out way beyond services, way beyond the Department of Defense ... (and) reach out to the civilian world, both in this country and abroad. And we're doing that," she said.

From a small, southern California town, the first chief of the new center joined the military on a medical school scholarship in 1985. Though the center's inception was more than two decades after her career choice was made, a resume that reflects a unique blend of education, training and experience in military and medicine and politics almost seems as if her whole career has been spent being groomed for her new position.

Sutton deployed to combat in the Gulf War as a division psychiatrist with 1st Armored Division and later served as division surgeon for 4th Infantry Division. Sutton commanded DeWitt Army Community Hospital, at Fort Belvoir, Va., and most recently commanded the U.S. Army Medical Department Activity, at Fort Hood, Texas.

In politics, she lettered at the highest level in the prestigious White House Fellows program, where she spent a year working as a special assistant to top-ranking government officials. She holds degrees in business, medicine and national security strategy.

But while her experiences have added up at this point to what some would consider a noteworthy career, Sutton's initial choice of serving in the Army over the other services was mostly happenstance, if not serendipitous.

"It never occurred to me (at the recruiting center) ... that I'd have to pick a service. I was getting ready to meet some of my high school buddies, and I only had a couple of hours, and the Army line was the shortest," Sutton said. "So I went and signed up for the Army, and it turned out it has been the best fit."

Five years later, in Operation Desert Storm, the young military psychiatrist was able to apply her military and medical training in combat working with soldiers. It was then, Sutton said, she knew she had made the right career choice.

"It turned my world upside down. It was then I realized ... this is what I love to do," she said. "I wanted to be in a position where, even if I could just make a little bit of difference to help (relieve) the hardships that they and their families have to bear, I wanted to do that."