PTSD: National Center for PTSD

Operational Priorities

The National Center for PTSD aims to continue our expertise in research and education to promote better understanding, diagnosis and treatment of PTSD. The field of trauma and PTSD studies continues to expand as research and educational demands to address prevention, resilience and recovery increase. The current context of provision of PTSD services to Veterans includes an influx of recently deployed young Veterans with acute PTSD, a growing number of female Veterans, and aging Veterans of previous wars with chronic PTSD.

VA has led efforts to recruit increasing numbers of mental health professionals who require training for PTSD care. The programs and priorities of the Center are shaped by this context. Our Center-wide Operational Priorities help us carry out the Center's mission accordingly. The first four priorities were established in 2013, along with an additional priority—research and education related to DSM-5—which was retired during fiscal year (FY) 2019. Much of the work in regard to DSM-5 has been completed, although efforts to validate measures and train providers to use DSM-5 instruments continue. The newest priority—PTSD and suicide—was added in FY 2017 to align with VA's focus on preventing Veteran suicide.

Center-wide Operational Priorities

1. Biomarkers: Establish reliable and valid biomarkers to aid in predicting who develops PTSD, diagnosing PTSD, predicting treatment outcome, and measuring treatment response.
2. PTSD and suicide: Investigate the relationship between PTSD and suicide and develop strategies to predict and prevent suicide among individuals with PTSD.
3. Treatment efficiency, effectiveness, and engagement:
   • Efficiency and effectiveness: Develop strategies to enhance the effectiveness of existing treatments including strategies to enhance treatment response in partial responders, and develop more effective treatments (especially with respect to medications).
   • Engagement: Develop strategies to enhance engagement in treatment.
4. Care delivery, models of care, and system factors:
   • Access: Develop strategies to enhance access to treatment, particularly using telehealth and technology (including the internet, mobile apps and social media), and including interventions that require little or no therapist involvement.
   • Non-specialty settings: Implement research, education, and consultation activities to enhance the delivery of PTSD care outside of specialty mental health settings, (e.g. in primary care, patient- aligned care teams (PACT), and general mental health, as well as community settings).
   • Measurement based care: Implement a research program on measurement based care; then develop educational materials and an implementation strategy.
   • Shared decision making: Implement research, education, and consultation activities to enhance shared decision making.
   • Models of care: Develop and evaluate models of PTSD service delivery.
5. Implementation: Create an infrastructure system for implementation activities.
   • Identify actionable items and develop an implementation strategy around them (e.g., for nicotine cessation, CBT-insomnia, and over-prescribing of benzodiazepines).
   • Develop a method for obtaining systematic feedback from the field.